Exactly 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 variety of reasons and many different factors can increase the chances of someone developing acid reflux.
Smoking is a large contributor with acid reflux and is believed to be the cause of a number of different problems that could lead to acid reflux disease (GERD).
Smoking damages the mucus membranes that protect the lining of the stomach from the effects of stomach acid. The swallowing reflex in the throat can also be damaged by nicotine making it difficult to eat properly and more likely that food and stomach contents will be regurgitated.
The acid secretions of the body can increase in smokers worsening the symptoms of acid reflux and heartburn. In the same way that smoking can weaken the swallowing reflex it can also weaken the Lower esophageal sphincter (LES). This is a ring of muscle that closes off the top of your stomach helping to keep 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 the production of saliva which we use to aid digestion and neutralize stomach acid.
It also increases the risk of certain types of throat cancer.
Long term acid reflux can lead to changes to the lining of the esophagus. Tissue changes to resemble the lining of the stomach, developing their own protective mucus layer. This condition, known as Barretts Esophagus leads to esophageal cancer in a small number of patients and needs to be regularly monitored.
Abnormalities in the stomach, such as a hiatal hernia can lead to an increased risk of acid reflux. Normally, the esophagus passes through our diaphragm connecting to the top of the. In someone who has a hiatal hernia, a small portion of the stomach and the LES gets pushed through and trapped above the diaphragm. Whenever we eat, food can get caught in this portion of the stomach, increasing pressure on the lower esophageal sphincter and causing acid reflux.
During pregnancy there is an increased risk of acid reflux especially in the third trimester when the baby is larger and puts pressure on internal organs. Changes in hormone levels also weaken the LES. These two factors combine, resulting in regular acid reflux and heartburn. Happily the symptoms disappear in the vast majority of cases when the baby is born.
Some foods, known as trigger foods have been linked to acid reflux disease and heartburn, although, rather than being the cause of acid reflux they tend to be the triggers that can set off symptoms in someone who has already developed acid reflux disease.
Alcohol, carbonated beverages, chocolate, citrus fruits, coffee or tea, fatty and fried foods, tomato based food and tomatoes,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 too soon after eating can lead to acid reflux as it increases the pressure inside 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 at the waist after a meal can put pressure on the stomach and lead to acid reflux.
Some medication such as aspirin and NSAIDs (non steroidal anti-inflammatory drugs) have been linked to acid reflux disease.
Happily, acid reflux disease can be controlled in most people with a mix of drugs to reduce acid levels and lifestyle changes and diet.