• Abnormality of the lower esophageal sphincter: The lower esophageal sphincter, which acts as a valve between the esophagus and stomach, becomes weak or stays open longer than normal, causing stomach acid to rise up into the esophagus. This abnormality is generally caused by the use of alcohol, tobacco, and some asthma medications.
• Abnormality of the esophagus: This type of abnormality slows the movement of food into the stomach or causes the stomach contents to flow back and remain in the esophagus longer than normal
• Abnormality of the stomach: This causes the stomach to empty more slowly and increases reflux symptoms. Fatty foods and chocolate reduce the stomach contractions.
• Diabetes: While the reasons for this are not known, it was reported in 2008 that GERD is found in approximately 40% of people with diabetes, especially those with complications of diabetes such as neuropathy,

A doctor will diagnose GERD and recommend a course of treatment when the above symptoms are observed. If the symptoms do not improve after following the doctor’s advice or receiving basic treatment, the following tests may be used to provide a more detailed diagnosis:

• Endoscopy
• Barium x-ray
• Nuclear medicine study
• Esophageal motility test
• Ambulatory pH test in the esophagus, which produces quick results

• Medications can heal the esophagus and reduce acid production
• Surgery may be used in the following cases:
  • In situations where medications are not helpful and the symptoms persist
  • In situations where a patient cannot take medications for extended periods or experiences side-effects

For most patients, the symptoms are not severe and can be reduced through the following simple lifestyle changes:

• Maintain a healthy weight
• Avoid tea, coffee, carbonated drinks, fruit juices, sour and spicy food, fatty food, and chocolate
• Avoid alcohol and tobacco
• Avoid eating a large meal for dinner, do not lie down immediately after a meal, wait at least 4 hours after eating before sleeping
• Avoid tight-fitting clothing or belts
• Eat smaller meals more often
• Sleep with your head raised at least 6 inches above the bed on a firm pillow
• Exercise regularly
• Avoid stress