What Causes Heartburn or Gastroesophageal Reflux Disease?

Dr. Duncan Miller, B. Sc, MD, discusses gastroesophageal reflux disease and heartburn.

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Dr. Duncan Miller, B. Sc, MD, discusses gastroesophageal reflux disease and heartburn.
Video transcript

Featuring Dr. Duncan Miller, BSc, MD

Duration: 3 minutes, 21 seconds
Gastroesophageal reflux disease is a fancy way of saying heartburn, and basically, what it means is that the stomach contents have regurgitated into your esophagus.

Thinking of it in a different way, what should normally be a one-way street has become a two-way street, and that can be manifest as the classic heartburn feeling, or burning your chest, or a belching, or a metallic taste in your mouth.

Things that can predispose to this are obesity because you've got a big stomach pushing on it, similarly, pregnancy. Your – that mass is pushing on your stomach and forcing things up. But a lot of other things in your diet can affect it – alcohol, tobacco, chocolate, and caffeine, and many medications can relax the bottom of your esophagus – the sphincter – and allow acid to come up.

Reflux is a concern because as acid comes up into your esophagus, it can lead to two problems. One is scarring or narrowing of your esophagus, so, food – especially solids like bread or meat – can't pass down. But more sinister is something called Barrett's esophagus. Barrett's esophagus is when your esophagus undergoes precancerous changes, and what's happened there is that the cells in your esophagus, they're normally stacked like a layer of pancakes.

The cells after your stomach in the small intestine are like a picket fence. When those cells in your esophagus are constantly exposed to acid, they think, "Well, it's not esophagus, I'm small intestine." So, they change from a stack of pancakes to that picket fence, and that's a precancerous change that can actually go on to becoming cancer.

So, what can you do to reduce your risk of reflux? Well, you want to optimize your weight. You want to stop smoking, minimize the amount of alcohol, of caffeine, you consume. It's also a good idea not to eat too close to bedtime just because if you have a stomach full of food, and then, you're lying down, it's more apt to, you know, come up.

Non-pharmalogical ways of treating it, similarly, are by elevating the head of your bed. Sometimes, putting a two-by-four under the feet of your bed – or the head of your bed, rather, will help gravity keep food down where it belongs. There's a variety of over-the-counter medication and prescription medication which can help reduce the symptoms and lower the acid in your stomach.

There are some concerning symptoms associated with reflux and these things should prompt very, you know, prompt medical attention. One of them is weight loss, trouble swallowing, if you find that you're getting full easily – all those things should make you see your family doctor or primary health care provider in a very short time.

If you have any questions at all about reflux, please, see your family doctor or primary healthcare provider. Just remember that treatment for your condition will vary with the individual and the condition they may have, so always consult your primary healthcare provider for more information.

Presenter: Dr. Duncan Miller, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor

Test Yourself ( 11 participated.)

Acid Reflux


I suffer from acid reflux


I take calcium based reflux tablets and they don't work very long


My problem seems as bad or worse


I burp and I have digestive upsets or worse


I want to reduce the burning natuarally

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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