Does heartburn run in your family? Genetics and GERD explained.

Is your family tree responsible for your reflux? Find out how genes may impact GERD and how you can manage your gut health effectively. 

What is GERD?

Many people are familiar with the burning feeling of common heartburn or acid reflux. Reflux can be serious stuff. When untreated, frequent reflux may lead to esophageal stricture (narrowing) and esophageal cancer, to name just a couple of issues. Despite lifestyle and medication treatments, sometimes reflux isn’t alleviated. In those cases, surgery may be recommended. 

But GERD is different. Gastroesophageal reflux disease (GERD) is often characterized by frequent reflux (more than twice a week). But reflux isn’t always a GERD symptom. Some people who have GERD may not even realize that what they’re experiencing is not normal for everyone. Symptoms of GERD can range from bad breath and frequent belching to the nagging feeling that you have something stuck in your throat. Other GERD symptoms may include vomiting, unintentional weight loss, and loss of appetite. When in doubt, get yourself checked out. 

The Role of Genetics in GERD Development 

Does Family History Matter For GERD Risk?

The possibility that the incidence of GERD and the risk of developing it may be tied to one’s genetics has been explored since the early 2000s. Through twin studies and other family studies, researchers have found that a family history of GERD is indeed a risk factor for developing GERD. It’s estimated that genetic influence on GERD is approximately 30%.

There has been some work on determining the genetic signaling that leads to GERD, although more research is needed to help determine genetic markers for GERD. Knowing that can help identify which people may be at the highest risk for developing GERD and are a priority for lifestyle interventions and treatments. One area where family history seems to have no effect is among those who need anti-reflux surgery (fundoplication). Having a primary relative with GERD also doesn’t seem to impact the outcomes of that surgery.  

Lifestyle Factors That Contribute to GERD

It’s Not All In The Genes

Of course, genetics are not the sole cause of GERD. It’s a multifactorial disease in which lifestyle factors play a big role. 

Foods That Fuel the Burn

Staying away from your known reflux triggers is a smart first step toward managing symptoms. For many people, this means avoiding certain types of foods and beverages, such as:

• foods high in fat
• citrus fruits
• carbonated beverages
• chocolate
• coffee and tea
• alcoholic beverages

Other Lifestyle Factors

While you might think that just avoiding trigger foods will take care of most symptoms, you may be surprised to learn that diet isn’t the only thing to consider.  Other factors such as being overweight, eating large meals or eating close to bedtime, being pregnant, and smoking may also contribute to GERD. Even the practice of wearing tight clothes or wearing a belt daily can contribute to frequent reflux. 

Reduce Your Risk of Reflux

In many cases, additional lifestyle changes can help put out the reflux fire. In an effort to find relief, you might be tempted to give every possible solution a try. In reality, your best bet might be to concentrate your efforts on a few impactful habits. 

Make Some Simple Changes

A recent, large study that used data from the Nurses’ Health Study II, found that among nearly 43,000 women, five lifestyle factors were independently associated with a decreased risk of developing GERD. These five factors were: 

• maintaining bodyweight between 18.5 - 25 BMI
• never smoking
• daily moderate to vigorous physical activity for 30 minutes
• drinking no more than 2 cups of coffee/tea/soda per day
• eating a healthy diet (high in fruits, veggies, lower in fat overall, including legumes, whole grains, seafood, and lean proteins)   

According to the researchers, even among regular users of anti-reflux medications, sticking with these healthy lifestyle habits could prevent approximately 40% of weekly GERD symptoms. 

Try Over-the-Counter Medications

Antacids are a simple, go-to medicine that many people rely on for occasional reflux. Histamine blockers are another type of over-the-counter (OTC) medication you can find at most drugstores. They usually include the compounds cimetidine, famotidine, or nizatidine. Keep in mind that even OTC medications come with side effects or may interfere with nutrients in your diet. Nevertheless, having these medications on hand can be helpful. If you do find that your reflux doesn’t respond to OTC medications or is persistent, you should see your physician.

Bottom line: A family history of GERD is a risk factor for developing GERD, but having a risk factor doesn’t mean it’s a sure thing. If you find yourself experiencing frequent reflux or any of the other symptoms of GERD, it’s a good idea to see your doctor for a diagnosis instead of trying to treat it yourself.

1. _{Argyrou, A., Legaki, E., Koutserimpas, C., Gazouli, M., Papaconstantinou, I., Gkiokas, G., & Karamanolis, G. (2018). Risk factors for gastroesophageal reflux disease and analysis of genetic contributors. World journal of clinical cases, 6(8), 176–182. https://doi.org/10.12998/wjcc.v6.i8.176}
2. _{Mehta, R. S., Nguyen, L. H., Ma, W., Staller, K., Song, M., & Chan, A. T. (2021). Association of Diet and Lifestyle With the Risk of Gastroesophageal Reflux Disease Symptoms in US Women. JAMA internal medicine, 181(4), 552–554. https://doi.org/10.1001/jamainternmed.2020.7238}
3. _{Misenhimer, J. J., Ward, M. A., Sanchez, C. E., Ngov, A., Shabbir, R., Ogola, G. O., Orsi, C., & Leeds, S. G. (2021). Family History of GERD Does Not Predict Anti-Reflux Surgery Outcomes. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 25(1), e2020.00102. https://doi.org/10.4293/JSLS.2020.00102}
4. _{Seeras K, Bittar K, Siccardi MA. Nissen Fundoplication. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519521/}