Causes

The exact causes of reflux disease are unknown. It is assumed that a congenital or acquired weakness of the connective tissue is causally involved in reflux disease or a hiatal hernia. Often, reflux disease occurs in combination with a hiatal hernia. However, the presence of a hiatal hernia is not mandatory for reflux disease to occur. Reflux disease is always triggered by an increased reflux of gastric acid into the esophagus, which attacks the esophageal mucosa. Factors promoting the disease include obesity, excessive consumption of alcohol and nicotine.

Symptoms

Sure signs of reflux disease are acid regurgitation, heartburn, and burning pain behind the sternum. Other signs may include nausea and vomiting, reflux of stomach acid or food particles down to the throat or mouth area (especially when lying down) with possible coughing fits, swallowing, belching of air and pain in the upper abdomen. Furthermore, sore throat, hoarseness and chronic throat clearing may occur. It is important to note that symptoms often do not correlate with the severity of esophagitis. For example, there may be severe esophagitis that causes little discomfort and vice versa. In the case of the most severe esophagitis (Barrett's esophagus), there is up to a 10 percent risk that within 10 years

the disease will become malignant and esophageal cancer will develop. Therefore, the above symptoms should always be clarified, treated if necessary, and followed up.

Frequency

It is the most common benign disease of the upper gastrointestinal tract in the western world. Approximately 10-25% of the population has typical reflux symptoms such as acid regurgitation and heartburn more or less frequently. Approximately 1/3 of those affected consult a doctor because of these symptoms.

Copyright Mischa Feigel, MD