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Causes of GERD | Severe, Persistent Acid Reflux Causes and GERD in Infants

Aug, 24 2026

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Acid reflux is one of the most common digestive disorders. It occurs when stomach contents, particularly acid and food, flow back into the esophagus instead of remaining in the stomach. This can cause uncomfortable symptoms such as heartburn, a burning sensation in the chest, a bitter taste in the mouth, or difficulty swallowing. The causes of acid reflux vary from person to person and may be related to weakness of the lower esophageal sphincter, certain dietary habits, or other health-related factors.

Medical Disclaimer: The content of this article has been medically reviewed to help ensure the accuracy of the information provided.

What Causes Acid Reflux and How Does It Happen in the Digestive System?

Acid reflux occurs when the lower esophageal sphincter does not function properly. This muscle acts as a valve between the esophagus and the stomach. Under normal conditions, it opens to allow food to pass through and then closes to prevent stomach contents from flowing back. However, when it becomes weak or relaxes frequently, stomach acid can flow back into the esophagus and irritate its lining.

The main factors that may contribute to acid reflux include:

Weakness or relaxation of the lower esophageal sphincter.
Increased pressure inside the stomach due to obesity or eating large amounts of food.
Delayed stomach emptying in some cases.
Hiatal hernia, which allows part of the stomach to move upward into the chest area.
Certain foods and daily habits that increase the likelihood of symptoms.

Repeated exposure to these factors may contribute to chronic acid reflux, especially when the underlying cause is not addressed.

Causes of Acid Reflux in Infants and Important Signs That Require Medical Attention

The causes of acid reflux in infants differ from those in adults in some ways. An infant's digestive system is still developing, and the muscle between the esophagus and stomach may not be fully mature during the first months of life, allowing milk or stomach contents to flow back upward.

Common causes and contributing factors include:

Incomplete development of the lower esophageal sphincter.
A primarily liquid-based diet.
Lying down for long periods after feeding.
Overfeeding or consuming more milk than the stomach can comfortably hold.
Allergies or intolerance to certain food components.

Acid reflux in infants is often mild and improves as the child grows. However, medical attention is recommended if the baby has poor weight gain, refuses feeding, experiences frequent forceful vomiting, or has blood in the vomit.

Causes of Severe Acid Reflux and When It Becomes a Concern

Acid reflux may progress from a mild problem to a more severe condition when acid repeatedly flows back into the esophagus and causes inflammation or damage to its lining. The causes of severe acid reflux vary depending on each person's condition, but several factors can increase its likelihood.

The main causes include:

Significant weakness of the lower esophageal sphincter.
Hiatal hernia.
Excess weight, which increases pressure on the stomach.
Eating large meals, especially before bedtime.
Smoking, which can affect the function of the lower esophageal sphincter.
Long-term use of certain medications that may worsen symptoms in some people.

Severe acid reflux may require medical evaluation, particularly when symptoms include severe chest pain, difficulty swallowing, unexplained weight loss, or persistent vomiting.

Causes of Acid Reflux During Sleep and How to Reduce Nighttime Symptoms

Some people experience worsening acid reflux symptoms while sleeping. This is mainly due to the horizontal position of the body, which can make it easier for stomach contents to flow back into the esophagus compared with standing or sitting.

Common causes of acid reflux during sleep include:

Eating immediately before going to bed.
Lying down after a heavy meal.
Eating foods that increase acid-related symptoms, such as fatty or spicy foods in some individuals.
Increased pressure on the stomach due to excess weight.

Nighttime symptoms may be reduced by avoiding food for an appropriate period before bedtime, elevating the upper body while sleeping, and limiting foods that trigger symptoms based on the individual's condition.

Causes of Persistent Acid Reflux and Factors That Increase Its Frequency

Persistent acid reflux refers to symptoms that occur repeatedly or continue for long periods. This may result from ongoing exposure to triggering factors or from an underlying condition that requires specialist evaluation.

The main causes of persistent acid reflux include:

Continued weakness of the lower esophageal sphincter.
Unhealthy dietary habits.
Eating large amounts of food or eating too quickly.
Excess weight.
Lack of physical activity.
Certain accompanying digestive disorders.

When symptoms continue for a prolonged period, a doctor may recommend specific tests to determine the severity of the reflux, assess its effect on the esophagus, and develop an appropriate treatment plan.

Can Food and Lifestyle Cause Acid Reflux?

Lifestyle can play an important role in increasing or reducing acid reflux symptoms. Some foods may not directly cause the condition, but they can trigger symptoms in people who already experience acid reflux.

Factors that may worsen symptoms include:

Eating high-fat foods.
Consuming large amounts of caffeinated beverages.
Eating chocolate or peppermint in some cases.
Eating large meals.
Smoking.
Physical inactivity and excess weight.

For this reason, making changes to daily habits alongside medical treatment can help control symptoms and reduce the frequency of acid reflux episodes.

How Is Acid Reflux Diagnosed and Treated, and When Should You See a Doctor?

The diagnosis of acid reflux is based on evaluating symptoms and medical history. In cases where symptoms are severe or unclear, a doctor may recommend additional tests, such as an upper gastrointestinal endoscopy or tests that measure acid levels in the esophagus.

Treatment varies depending on the severity of the condition and may include:

Changes to diet and lifestyle.
Medications that reduce stomach acid production under medical supervision.
Treatment of contributing conditions such as obesity or hiatal hernia.
Advanced medical procedures for cases that do not respond to conventional treatment.

It is recommended to consult a digestive system specialist if symptoms persist or if unusual warning signs appear, such as difficulty swallowing, bleeding, or unexplained weight loss.

Book Your Consultation with Gastroenterology Specialists at Smouha Scope

If you experience recurring acid reflux symptoms or need an accurate evaluation of your condition, Smouha Scope Center in Alexandria provides specialized services for diagnosing and treating digestive system disorders using advanced endoscopic techniques. The center's medical team can help identify the underlying cause and determine the most appropriate treatment approach.

Frequently Asked Questions About the Causes of Acid Reflux

What Are the Most Common Causes of Acid Reflux?

The most common causes include weakness of the lower esophageal sphincter, increased pressure on the stomach, foods that trigger symptoms, and excess weight.

Are the Causes of Acid Reflux in Infants Normal?

Yes. Acid reflux in infants is often related to the incomplete development of the lower esophageal sphincter and usually improves gradually as the child grows. However, certain warning signs require medical evaluation.

What Causes Acid Reflux During Sleep?

Common causes include eating before bedtime, lying down immediately after meals, and increased pressure inside the stomach, all of which can make it easier for acid to flow back into the esophagus.

Is Persistent Acid Reflux Dangerous?

It is not dangerous in every case, but persistent symptoms over a long period should be medically evaluated to help prevent complications such as inflammation of the esophagus.

Can Acid Reflux Be Cured Permanently?

This depends on the underlying cause. Some people experience significant improvement through lifestyle changes and appropriate treatment, while others may require long-term follow-up.