Gerd Causes

GERD causes vary. For many people, a hiatal hernia is the root cause of GERD symptoms, but hiatal hernias are only one of several possible GERD causes. Eating habits, smoking, medication and other factors can also contribute to GERD.

GERD Causes and the Lower Esophageal Sphincter

All causes of GERD affect the lower esophageal sphincter: the ring of muscular tissue at the junction of the stomach and the esophagus. If the lower esophageal sphincter is damaged or otherwise impaired it becomes “incompetent.” An incompetent lower esophageal sphincter relaxes at inappropriate times, allowing acidic stomach contents to escape into the esophagus.

Hiatal Hernia and GERD

A hiatal hernia is a hernia that occurs at the opening of the diaphragm where the esophagus meets the stomach. “Hiatal” means “opening.” If the muscles that ring the diaphragm opening become weak or damaged, the upper portion of the stomach protrudes through the diaphragm opening.

A hiatal hernia prevents the diaphragm muscles from supporting the lower esophageal sphincter. The sphincter becomes incompetent, and GERD occurs.

Hiatal hernias are a common occurrence: Approximately one quarter of individuals over age fifty develop them. Women are more likely to develop hiatal hernias than men, and both genders are more likely to suffer from hiatal hernias if they’re overweight.

Not all hiatal hernias are considered causes of GERD. A small hiatal hernia is usually asymptomatic (producing no symptoms), and often goes undiagnosed. The risk of GERD increases with the size of the hiatal hernia.


Impaired muscle function or nerve damage can prevent the stomach from emptying properly. Called gastroparesis, or delayed gastric emptying, this condition is one of the GERD causes. The stomach’s inability to empty puts pressure on the lower esophageal sphincter.

Medication as Causes of GERD

Certain medications are known GERD causes. Tranquilizers have been linked to GERD, most notably benzodiazepines and theophylline. Benzodiazepines include Valium® and Xanax®. Theophylline is used as an asthma medication.

NSAIDs (non-steroidal anti-inflammatory drugs) do not cause GERD, but they are known to aggravate GERD symptoms in some people. Aspirin and Tylenol are both NSAIDs.

Eating Habits and GERD Causes

Eating habits can intensify GERD symptoms and the effects of a hiatal hernia. Being overweight or obese may cause GERD and increase the risk of a hiatal hernia.

Overeating places pressure on the lower esophageal sphincter, which can trigger acid reflux and heartburn. Certain foods are considered GERD symptom causes, and are likely to trigger acid reflux in people with GERD. These foods include:

  • chocolate
  • citrus fruits
  • fatty foods
  • fried foods
  • peppermint
  • spicy foods
  • tomato-based foods.

Additionally, certain beverages can trigger GERD. Citrus fruit drinks, alcohol and caffeine are all possible causes of GERD symptoms.

Smoking and GERD

Smoking is a suspected GERD cause. Smoking may weaken the lower esophageal sphincter muscles, increasing the risk of GERD. Smoking also reduces the amount of saliva the body produces, which helps clear acid out of the esophagus.

GERD Causes and Gravity

Gravity and body position are not GERD causes, but they certainly influence the severity of GERD symptoms, especially if a hiatal hernia is present. Lying down after eating, lifting something heavy and bending forward all bring gravity to bear on the lower esophageal sphincter, increasing the chance of a GERD episode.


Beers, M.H.