Causes of GORD

Gord is caused by acid contents of the stomach moving back up the oesophagus. Increased acid production in the stomach and structural problems that allow acid reflux can precipitate the situation.

The following common factors may contribute to reflux:

• Overeating. The more the stomach is stretched by food, the higher the tendency to reflux.
• Fatty meals also increase this tendency, because fat delays the emptying of the stomach and causes the oesophageal sphincter to relax, letting acid reflux into the oesophagus.
• Smoking increases stomach acidity and can also cause the oesophageal sphincter to relax.
• Pregnancy increases pressure in the stomach and may cause reflux.
• Obesity can also increase pressure in the abdomen, causing reflux.
• Over-the-counter medications may lead to heartburn.
• Some foods and beverages stimulate stomach acid secretion, which can lead to heartburn.

The following are examples of irritants that may cause heartburn:
– Acidic foods, e.g. tomatoes
– Ibuprofen and aspirin
– Acidic fruit juices, especially citrus
– Alcohol
– Coffee
– Fizzy drinks
–Chocolate

Diseases of the oesophagus

Diseases of the oesophagus can also cause heartburn. Examples of such diseases are scleroderma and sarcoidosis.

Hiatus hernia

Hiatus hernia is a common cause of heartburn.

There is a slit-like opening in the diaphragm through which the oesophagus passes. A hiatal hernia occurs when a section of the upper stomach moves through this opening in the diaphragm upwards into the chest, preventing the muscle fibres of the diaphragm from closing the lower end of the oesophagus.

The oesophagus remains open, allowing stomach acid to enter. Hiatus hernias commonly occur in people over 50.

Previously reviewed by Dr Ganief Adams, Gastroenterologist, MBChB (UCT), FCP (SA)
Reviewed by Dr Jenny Edge, General Surgeon, BSc, MB BS, FRCS (Edin), M Med (Stell.)