Precisely what is the cause of acid reflux disease in adults is still the subject of ongoing research.
People can develop acid reflux disease for a number of different reasons and many different factors can increase the chances of someone developing acid reflux.
Smoking is a big factor with acid reflux and is known to cause quite a few different problems that could lead to GERD (Gastro Esophageal Reflux Disease).
Smoking damages the mucus membranes that protect the lining of the stomach from the corrosive effect of stomach acid. Our swallowing reflex in the esophagus can also be impaired or damaged by smoking making it difficult to eat properly and more likely that food and stomach contents will be regurgitated.
Smokers have increased levels of acid secretions that can worsen the symptoms of acid reflux and heartburn. It can also weaken the Lower esophageal sphincter (LES). This is a ring of muscle that seals the top of the stomach keeping your stomach contents in.
When this is weakened it makes it easier for food and stomach acid to be refluxed back into the esophagus, causing heartburn.
Smoking can also reduce saliva production which the body uses to help with digestion and neutralize the acid in our stomach.
It can also increase the risk of some forms of throat cancer.
Long term acid reflux can lead to changes to the tissue that lines the esophagus. Tissue changes to resemble the cells that make up the lining of the stomach, developing their own protective mucus layer. This condition, known as Barretts Esophagus can lead to esophageal cancer in a small percentage of sufferers and needs to be regularly monitored.
Abnormalities in the stomach, such as a hiatal hernia can also cause an increased risk of acid reflux disease. Normally, our esophagus passes through the diaphragm to the stomach. In someone who has suffered a hiatus hernia, a small portion of the stomach and the LES is pushed back up through and trapped above the diaphragm. When we eat, some food can get caught in this part of the stomach, putting pressure on the lower esophageal sphincter and causing acid reflux.
In pregnancy there is an increased risk of acid reflux especially in the third trimester when the baby can put pressure on the stomach. Changes in hormone levels also reduce the effectiveness of the LES. These two factors combine, resulting in regular heartburn and acid reflux. Fortunately the symptoms disappear with most people as soon as the baby is born.
Certain foods, commonly known as trigger foods have been linked to acid reflux and heartburn, although, rather than being the cause of acid reflux they tend to be triggers that set off the symptoms in someone who has already developed acid reflux disease.
Alcoholic drings, fizzy drinks, chocolate, citrus fruits, coffee or tea, fatty and fried foods, tomatoes and tomato based food,garlic and onions, mint and spices and spicy food are all attributed with worsening acid reflux disease in some people.
Other things that can cause acid reflux are :
Exercise, especially too soon after eating can cause acid reflux as it increases the pressure within the abdomen.
Eating late in the evening can lead to night-time reflux.
Being overweight which puts added pressure on internal organs including the stomach.
Bending over at the waist after eating increases pressure on the stomach and lead to acid reflux.
Certain drugs such as NSAIDs and aspirin have been linked to acid reflux.
Fortunately, acid reflux disease can be controlled in most people with a mix of drugs to reduce acid levels and lifestyle changes and diet.