Gastroesophageal reflux disease (GERD) is a common chronic condition that causes acid reflux or heartburn. Genetics can play a role in the development of the disease, affecting body processes that control inflammation, acid secretion, and esophageal function.

GERD is a long-term medical condition that can result in heartburn and regurgitation. Around 20% of the population in the United States has GERD, and it is more common in people who are elderly, have obesity, or are pregnant.

The American College of Gastroenterology (ACG) explains that GERD occurs when gastric acid and bile from the stomach refluxes into the esophagus. Usually, a valve called the lower esophageal sphincter (LES) prevents this from happening. However, certain foods, lifestyle factors, or medical conditions can weaken the valve and allow acid to flow back into the throat.

Gastric fluids damage the cells lining the esophagus, and GERD can lead to complications such as peptic ulcers, cancer, or Barrett’s esophagus.

In this article, we will look at genetic factors that may play a role in GERD occurring. We will also discuss risk factors, treatment options, and prevention strategies for GERD.

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A 2018 review indicates that genetic factors play a major role in GERD and GERD-related disorders such as Barrett’s esophagus and esophageal adenocarcinoma. Twin and family studies reveal that the heritability of GERD is around 31%.

The review found that genetic polymorphisms, or DNA variations, of the following genes may increase the risk of GERD:

  • FOXF1
  • MHC
  • GNB3
  • CCND1

For example, the FOXF1 gene may play a role in the development of the gastrointestinal smooth muscle and may help regulate the LES.

The review also explains that pro-inflammatory cytokine genes interleukin-1beta and IL-1RN can reduce acid and protect against GERD developing in the presence of Helicobacter pylori infection. However, altered expression of the following genes involved in inflammation, DNA repair, and growth factor processes can increase the risk of GERD:

  • COX-2
  • IL-10
  • glutathione-S-transferases (especially GSTP1*b)
  • CCND1
  • XRCC1
  • hMLH1
  • A61G

Experts suggest that people who are overweight or have obesity are at more risk of developing GERD.

According to a 2017 study, abdominal obesity increases abdominal pressure, causing the LES to relax and not function properly. In addition, the study found links between genes predisposing someone to metabolic syndrome and the risk of GERD.

A hiatal hernia can also increase the chance of getting GERD or make GERD symptoms worse. In addition, smoking, pregnancy, and certain medications are risk factors for GERD.

The ACG advises that treatments for GERD aim to eliminate symptoms, heal the irritation in the esophagus, and prevent long-term complications. They note that doctors may prescribe H2 receptor antagonists and proton pump inhibitors (PPIs) to reduce the amount of acid the stomach produces. However, these medicines are treatments and not cures.

People can also buy antacids over the counter. However, these may only treat mild GERD symptoms, and a person should talk with their doctor to see if they are suitable. In addition, a doctor may recommend dietary and lifestyle changes.

If someone’s symptoms do not improve, a doctor may recommend surgery. Fundoplication is the most common surgery for GERD. The procedure involves a surgeon sewing the top of the stomach around the end of the esophagus to help prevent reflux. Doctors may also recommend endoscopy procedures or bariatric surgery.

To manage symptoms and prevent GERD from occurring, a doctor may recommend the following strategies.

Dietary changes

A doctor may advise someone with GERD to avoid the following foods and drinks:

  • fatty and fried foods
  • chocolate
  • caffeinated drinks
  • citrus fruits and juice
  • tomatoes and tomato juice
  • alcoholic drinks
  • mint
  • spicy foods

Lifestyle changes

The following lifestyle changes may also help someone with GERD.

  • losing weight if overweight
  • stopping smoking, if they smoke
  • avoiding tight clothing
  • limiting or avoiding alcohol
  • raising the head of their mattress 6–10 inches using a foam wedge
  • avoiding laying down or going to bed for at least 2 hours after eating

Research indicates that genetic factors may play a major role in the development of GERD and related conditions. Variations in genes that control inflammation, DNA repair, and growth factors may be involved, as well as genes that contribute to the function of the lower esophageal sphincter.

Obesity and overweight may develop due to some gene variations associated with metabolic syndrome. This may cause abdominal pressure and reduce the ability of the esophageal sphincter to stop acid reflux. People can discuss treatment options with their doctor, including dietary and lifestyle changes, medications, or surgery.