Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disorder in the United States. It occurs when the lower esophageal sphincter does not close properly, and stomach acid comes back up into the esophagus. 

Normally, the lower esophageal sphincter, which is a ring of muscle located at the end of the esophagus leading into the stomach, acts as a barrier between the stomach and the esophagus to prevent food and harmful gastric acid from entering the esophagus. 

When gastric acid touches the lining of the esophagus, there is a burning sensation in the chest or throat. This burning sensation is referred to as heartburn. When you can taste the acid in the back of your throat, it is referred to as acid indigestion. 

If you have heartburn occasionally, you do not necessarily have GERD. Occasional heartburn is common, but it is not considered GERD. Heartburn that occurs more than twice a week may be GERD. 

At Yale Bariatric/Gastrointestinal Surgery, our innovative surgeons perform minimally invasive procedures, many of which are at the leading edge of gastrointestinal surgery, to treat GERD. Our multidisciplinary team works collectively to create personalized treatment plans that provide the best options for each patient, reflecting his or her specific condition and individual needs.

Causes of GERD

The most common reason for GERD is a defective lower esophageal sphincter (LES), which is a ring of smooth muscle fibers where the esophagus and the stomach join. If the LES is loose, then and gastric juice and food are allowed to flow freely back into the esophagus. 

Hiatal hernias sometimes cause GERD. In the case of a hiatal hernia, a portion of the esophagus slides up into the chest region. 

Certain medical conditions and foods may also exacerbate GERD. These include: 

  • Obesity 
  • Pregnancy 
  • Alcohol 
  • Smoking 
  • Chocolate 
  • Caffeine 
  • Spearmint and peppermint 
  • Fatty foods 
  • Cola 
  • Milk 
  • Citrus juices 
Medicines that may exacerbate GERD include: 

  • Oral contraceptives 
  • Nitrates 
  • Theophylline 
  • Calcium channel blockers 
  • ß-adrenergic agonists
  • a-adrenergic agonists 
  • Diazepam 
  • Dopamine 
  • Nicotine patch 
  • Aspirin and NSAIDS (i.e. ibuprofen) 
  • Tetracycline 
  • Potassium 
  • Iron


The main symptoms of GERD can be divided into typical and atypical symptoms. 

Typical symptoms include a burning sensation or heartburn in the chest and regurgitation of food or stomach content. These symptoms are general and are not necessarily specific for reflux disease. Regurgitation, for example, is a relatively common complaint. 

Atypical symptoms of GERD may include: 

  • Asthma 
  • Chronic sinusitis 
  • Chronic hoarseness 
  • Difficulty swallowing (dysphagia) 
  • Vomiting 
  • Choking sensation at nighttime 
  • Pneumonias 
  • Excessive salivation 
If you have one or more of the above symptoms, it does not mean that you have GERD. If you think that you have GERD, please contact your doctor.

Make An Appointment

Yale Bariatric/Gastrointestinal Surgery Program
40 Temple Street, Suite 7B
New Haven, CT 06510

T 203.785.6060 or 203.785.2616
F 203.785.6666

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