The causes of GERD are not straightforward. In many cases, there may be several causes contributing to the problem. In some patients it will be to do with over-production of acid, although this is relatively rare. The main factors which cause GERD are the strength of the muscles of the lower oesophagus (lower oesophageal sphincter), the emptying of the stomach, defective oesophageal contractions and hiatal hernias, which can also cause reflux.

The lower oesophageal sphincter, or LES is the most crucial factor within the mechanism for stopping acid reflux. It control the passage between the oesophagus and the stomach, and opens to let food enter whilst closing primarily to block reflux. If this muscle is weakened this can lead to increased reflux, and can be the result of a specific more complex medical complaint, and can be classified in two distinct categories: weakened contractions and abnormal relaxations.

With weakened contractions, the LES does not do enough to prevent reflux from occurring, as the can last for a considerable period and do not accompany the swallow. Extended periods of relaxation allow reflux to flow, as the LES remains open for a considerable period. These are seen as the main abnormalities which can occur as a result of weakened oesophageal muscles.

Another contributory factor to reflux is the hiatal hernias, which the majority of GERD patients will suffer from. It is unclear why these hernias develop in patients of GERD, but they're effects are almost fully understood. When a hiatal hernia is present, part of the stomach has pushed up into the diaphragm which partitions the abdomen from the chest. The diaphragm is a key factor in preventing reflux and works with the LES to ensure any reflux is kept to a minimum. In patients with the hernia, this process is lessened because of its affects on the diaphragm, which leads to increased reflux. The fact that a portion of the stomach is pushed into the diaphragm means that it is ideally suited to trapping acid, which can again lead to acid reflux which higher volumes of acid remaining close to the lining of the oesophagus.


The contraction of the oesophagus is an important feature of the digestive process. It forces food down towards the stomach, where digestion can begin. Patients with GERD can sometimes find that the root of their problem lies in defective contractions of the oesophagus, which as a result fail to push reflux back towards the stomach for whatever reason. It could be to do with the weakened pressure of the muscular contractions, or perhaps have developed as a result of smoking which tends to trap acid within the oesophagus for up to five to six hours.

There are many different causes of this uncomfortable condition. Because of the acidic nature of the complaint, patients will often feel a burning sensation, and may be oblivious as to the reasons they are feeling this discomfort. It is best to consult your medical professional, who will have a better idea as to the precise cause of your reflux, and will be better placed to offer a diagnosis and effective course of treatment.

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