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What’s Behind Your GERD? Understanding the Causes and How to Find Answers

What’s Behind Your GERD? Understanding the Causes and How to Find Answers

May 23, 2025
Doctor speaking to elderly man

Understanding what's behind your GERD (Gastroesophageal Reflux Disease) is the first step toward lasting relief, and that starts with identifying the root cause through the right diagnostic tools. 

At Hoag, we believe that the first step to lasting relief is understanding the why behind your symptoms. Here’s a closer look at what causes GERD, and how we get to the root of it to help you feel better.

What Causes GERD?

There’s no single cause of GERD, which is why pinpointing your personal triggers is so important. Here are the most common culprits:

Lifestyle Factors

Your everyday habits can significantly impact acid reflux:

  • Diet (especially spicy, acidic, or fatty foods)

  • Obesity

  • Smoking

  • Alcohol consumption

Medical Conditions

Some underlying health issues can make GERD worse:

  • Hiatal hernia

  • Delayed gastric emptying

  • Connective tissue disorders (like scleroderma)

Medications

Certain medications can relax or weaken the lower esophageal sphincter (LES), making reflux more likely:

  • Pain relievers (NSAIDs)

  • Calcium channel blockers

  • Sedatives

Weak LES Function

The lower esophageal sphincter is the muscle that acts like a valve between the esophagus and stomach. If it’s weakened or doesn’t close properly, stomach acid can escape into the esophagus, leading to classic GERD symptoms.

How Do We Find the Cause?

At Hoag, we offer a comprehensive range of diagnostic tools to identify the root cause of your reflux. These tests help us tailor treatment specifically to you:

Initial Evaluation

  • Patient history & physical exam

  • Discussion of symptoms like heartburn, regurgitation, chest pain

  • Identification of lifestyle or dietary triggers

Innovative Testing at Hoag

Esoguard (Only at Hoag!) 

EsoGuard is a noninvasive, in-office DNA test that helps detect abnormal esophageal cells that may result from chronic or uncontrolled GERD. It can identify early signs of conditions like Barrett’s esophagus, dysplasia (precancerous changes), or even esophageal cancer—making it a powerful tool for early detection and peace of mind. Hoag is proud to be the only hospital in California currently offering this advanced technology.

Upper GI Endoscopy or EGD

An Endoscopy uses a small scope with a camera, so we can closely examine the anatomy of your esophagus, check for a hiatal hernia, and take tissue samples if needed. This allows us to detect inflammation, ulcers, or abnormal cell growth with precision.

Esophageal pH Monitoring

This test tracks how often acid enters the esophagus and when. There are two methods:

  • Catheter Monitoring: A small tube through the nose

  • Capsule Monitoring: A wireless capsule placed in the esophagus

Esophageal Manometry

Measures the strength and coordination of esophageal muscle contractions during swallowing.

Barium Swallow X-ray

After drinking a barium solution, X-rays are taken to highlight abnormalities in the esophagus and stomach.

Other Advanced Diagnostics

  • Abdominal Ultrasound

  • Capsule Endoscopy

  • Gastric Emptying Test (GET)

  • Video Esophagram

What Happens After Diagnosis?

Once we understand what’s causing your GERD, we can move forward with a treatment plan tailored to you. This might include:

  • Lifestyle changes (like diet or sleep position adjustments)

  • Medications to reduce stomach acid or strengthen the LES

  • Endoscopic or surgical options for more severe cases

We also differentiate GERD from Eosinophilic Esophagitis (EoE), which is a less common condition with similar symptoms but different causes and treatments.

Regular follow-up care ensures your treatment stays effective and adjusts as your body changes.

Moving Forward with Confidence

At Hoag, we combine advanced diagnostics with compassionate care to uncover the real reason behind your GERD symptoms. With the latest tools including Esoguard and wireless acid testing, and a team dedicated to your digestive health, we’re here to help you move from discomfort to relief.

If you’ve been dealing with persistent heartburn, regurgitation, or unexplained chest pain, don’t wait to get answers. Contact a Hoag doctor to explore what’s really going on. Our GI physicians and specialists use advanced diagnostics and a personalized approach to get to the root of GERD, so you can start feeling better.

Return to GERD hub here.


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