This picture shows the mechanism behind gastric reflux.GERD is caused by transient lower esophageal sphincter relaxation. Other causes are pregnancy, hiatus hernia, increaseed gastric acidity, obesity, or decreased esophageal motility. Symptoms of GERD are heartburn lasting for more than half an hour after food, regurgitation, and dysphagia. Treatment is by life style modifications (Don't lie down after eating, avoid spicy food), medical treatment starts with H2 blockers such as ranitidine, then proton pump inhibitors such as omeprazole can be used. Surgical treatment is by a procedure called nissen fundoplication.