Gastroesophageal reflux (GER) happens when the muscle ring (or lower esophageal sphincter) at the bottom of the tube that carries food to the stomach (the esophagus) doesn't stay closed when it should. As a result, contents in the stomach, including digestive acids, flow back into the esophagus.

People who have GER often complain of a burning sensation in the chest or throat (heartburn or acid indigestion). They also suggest they can taste food or bitter fluid in the back of the mouth. In children aged 12 and younger, reflux often can occur without heartburn but a dry cough, asthma symptoms, or difficulty swallowing instead.

When it happens only occasionally, GER is not a problem. If, however, it occurs more than twice a week, GER is known as gastroesophageal reflux disease (GERD). When GERD is left untreated, it can cause serious health problems, including:

• Inflammation and damage (bleeding or ulcers) in the lining of the esophagus

• Scars, which can narrow the esophagus and inhibit swallowing

• Damage to cells in the esophageal lining, which can lead to esophageal cancer

GERD also can contribute to or worsen asthma, coughing, and pulmonary fibrosis.

People of all ages can have GERD. Many infants with reflux symptoms and who vomit or spit up often are healthy and outgrow GER by their first birthday. Reflux that continues after a child turns 1 might be GERD. If your child has GER symptoms, be sure to ask your Summit Medical Group pediatrician what he or she recommends.

What Causes GERD

Although there's no definitive cause for GERD, researchers believe certain abnormalities such as hiatal hernias can contribute to it. Obesity, smoking, and pregnancy also can contribute to GERD.

Certain foods also can worsen reflux, including:

• Citrus fruits and drinks

• Chocolate

• Alcohol

• Caffeinated drinks

• Fatty and fried foods

• Garlic and onions

• Mint and mint flavoring

• Spicy foods

• Tomatoes and tomato-based foods and sauces

In addition to avoiding irritating foods and drinks, people with GERD should:

• Eat small meals

• Wear loose-fitting clothes

• Avoid lying down for 3 hours after a meal

• Sleep with head and shoulders raised 6 to 8 inches

"The good news is that GERD can be successfully treated and managed," says Summit Medical Group gastroenterologist Adam F. Barrison, MD. "In addition to effective dietary and lifestyle changes, medication can help manage GERD. In more severe cases," Dr. Barrison notes, "surgery may be an option."