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GERD, Hiatal Hernia and Heartburn
Gastroesophageal reflux disease (GERD) is a disorder affecting the lower esophageal sphincter (LES) - a ring of muscle between the esophagus and the stomach. Under usual circumstances, the LES opens to pass food into the stomach and then closes to prevent food and the acidic stomach juices from flowing back into the esophagus. GERD occurs when the LES is weak or relaxes inappropriately and allows the stomach contents to flow into the esophagus.
What factors can contribute to GERD?
Certain foods and beverages: chocolate, peppermint, fried or fatty foods, coffee, tomatoes, and alcohol can weaken the LES and make reflux worse. Obesity, smoking, and pregnancy can also cause GERD.
What is a hiatal hernia?
Hiatal hernia occurs when the upper portion of the stomach protrudes through the diaphragm. This is caused by a weakening of the muscle of the diaphragm. The opening in the diaphragm usually acts as an additional sphincter around the lower end of the esophagus. Patients with hiatal hermias are prone to reflux of acid and stomach contents above the opening.
Heartburn
Heartburn is the most common symptom of GERD. It feels like a burning chest pain behind the breastbone and/or up the neck and throat. Some patients feel food or bitter/acid fluid coming back into the mouth. Heartburn is often worse after eating and can last up to two hours. Lying down and bending over after a meal will make the symptoms worse.
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