Heartburn can arise from many places—a heavy pasta dinner, an afternoon jog, a panic attack from a missed train. However, heartburn can typically be prevented by taking prescription or over-the-counter medicine, or by enacting lifestyle changes that focus on factors such as diet, exercise, and stress. But what if you had no say in heartburn? What if it were a genetic disease?

GORD, a condition where the stomach's acidic contents refluxes into the oesophagus, is the most frequent case of indigestion in the United Kingdom,1 and one of its symptoms is heartburn. (GORD is the same as GERD.) In 2003 researchers from Sandwell General Hospital in England set out to study the genetic influences in gastro-oesophageal reflux disease (GORD). To compile data, they asked 4,480 fraternal and identical twins to complete symptom questionnaire. What they discovered was that the genetic contribution to GORD was "substantial."2

These types of studies are both relatively new and extremely important. Before them, it was difficult to say whether heartburn in the family—for example, a mother and her son—was a genetic disease or a case of shared environments; that is, for example, the parent and child may have been eating a lot of fatty foods that contributed to heartburn. But research in the last ten years has begun to indicate the former—that heartburn is an inherited trait.

In 2001 researchers went to the Swedish Twin Registry to investigate the genetic influence in the development of reflux. They found that inherited obesity or alcohol use did not cause reflux, and that inherited smoking may be a minor factor. Their conclusion was that reflux is caused by genetic rather than shared environmental effects.3

A more recent study (2007) set out to determine the contribution of genetics in GERD, among other diseases. In the abstract background, it labeled the genetic contribution to GERD as having been "proposed" but "controversial." Yet, it arrived at the same conclusion as the other two studies. "There is," the authors said, "a genetic contribution to GERD."4

With the link between genetics and heartburn firmly established, a further question arises: does the fact that genetics contribute to heartburn make heartburn a genetic disease?

The answer is no. Labeling heartburn a genetic disease discounts years of research and understanding about what contributes to heartburn. And it's not just diet, exercise, and stress. On its website, the National Heartburn Alliance lists many other causes, including horizontal body positions, being overweight, wearing restrictive clothing, and medical reasons, which can even include pregnancy. Adding genetics to the list doesn't exclude the others.

 

 

Sources:

1. www.netdoctor.co.uk

2. N J Trudgill, “Genetic influences in gastro-oesophageal reflux disease: a twin study,” Gut, 2003

3. Alan J. Cameron, “Gastroesophageal reflux disease in monozygotic and dizygotic twins,” Gastroenterology, 2002

4. N. J. Talley, “Influence of genetics on irritable bowel syndrome, gastro-oesophageal reflux and dyspepsia: a twin study,” Alimentary Pharmacology & Therapeutics, 2007