GERD: What Is It?
A digestive condition known as gastroesophageal reflux disease, or GERD, damages the muscular ring between your esophagus and stomach. The lower esophageal sphincter is the name of this ring (LES).

If you have it, you can get acid indigestion or heartburn. Doctors speculate that certain patients may be affected by the ailment known as hiatal hernia. In most situations, dietary and lifestyle modifications can reduce your GERD symptoms. Though some people could require treatment or surgery.


GERD Causes
The stomach and esophagus are referred to as the "gastroesophageal" system. Reflux is defined as a backflow or return. When stomach contents reflux into the esophagus, it is referred to as gastroesophageal reflux.

Your LES opens to let food enter your stomach during regular digestion. Then it closes to prevent food and stomach juices that are acidic from returning to your esophagus. When the LES is weak or relaxes when it shouldn't, gastroesophageal reflux results. This enables the contents of the stomach to pass into the esophagus.


GERD Risk Factors
Recent research indicates that GERD in infants and children is more prevalent than previously believed. Recurring episodes of vomiting may result from it. Additionally, it may result in coughing and other respiratory issues.

A hiatal hernia, in the opinion of some medical professionals, may weaken the LES and increase your risk of gastroesophageal reflux. A hiatal hernia occurs when the top portion of your stomach pushes through a small gap in your diaphragm and into your chest (diaphragmatic hiatus). The muscle dividing the chest and abdomen is known as the diaphragm.

Many persons with a hiatal hernia won't have reflux or heartburn symptoms. However, a hiatal hernia may make it easier for stomach contents to reflux into the esophagus.

A hiatal hernia can result from straining, vomiting, coughing, or any rapid physical activity that increases your abdominal pressure. Many older adults (50+) in otherwise good health have a tiny one. Hiatal hernias can affect persons of any age, despite the fact that they typically occur in middle life.

Typically, hiatal hernias don't require medical attention. However, if the hernia is at risk of being strangulated or twisted in a way that shuts off blood supply, it might be necessary. If you also have severe GERD or esophagitis, you might also need to treat it (inflammation of the esophagus). To reduce the hernia or avoid strangling, your doctor might operate.

Other factors that may increase your risk of developing GERD include:
- Being obese or overweight
- Pregnancy
- Delay in stomach emptying (gastroparesis)
- Connective tissue conditions such lupus, scleroderma, or rheumatoid arthritis

If you already have acid reflux, your diet and lifestyle choices may aggravate it:
- Smoking
- Several meals and beverages, such as chocolate, fried or fatty foods, coffee, and alcohol
- Hefty meals
- Eating just before going to bed
- Several drugs, including aspirin

Reference:
https://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1