Here is my latest acid reflux information.
The cause of acid reflux disease is quite complex and cannot be pinned to just one symptom. In many patients there are multiple causes but not all patients have the same ones. It is quite common for different patients with GERD (gastro esophageal reflux disease) to have entirely different causes. You would think that excess stomach acid would be the main problem but this is only found in a small number of patients.
The main cause of GERD is found to be problems with the lower esophageal sphincter or LES for short. The esophagus is the muscular tube that extends from the throat and connects to the stomach. The esophagus is part of the upper gastro intestinal tract that delivers food from the mouth to the stomach. The esophagus is constantly in use; every time we swallow the esophageal muscles rhythmically push the contents down into the stomach. At the base of the esophagus there is the LES, a ring of muscle where it connects to the stomach.
The LES acts as a valve constricting and closing off access to the stomach, and works in conjunction with the esophagus. When we swallow the LES opens for a short time to allow the contents of the esophagus to enter the stomach. It then should close firmly to prevent any stomach contents from refluxing back up. If you suffer from heartburn it is because the LES has allowed stomach contents to somehow pass back into the esophagus. These contents contain acid and burn the lining of the esophagus which is where the pain comes from. For patients with GERD acid refluxing is pretty common and largely due to defects of the LES.
One of the problems is when the LES muscles are weakened, and this will decrease its ability to close off properly which will allow stomach acid to reflux. The second problem is abnormal relaxations of the LES muscles called transient LES relaxations. They are abnormal in that they do not work in conjunction with the esophagus when we are swallowing and happen at anytime. They can also last for much longer than normal up to a few minutes at a time. This allows acid reflux to take place easily and more frequently. After meals when the stomach is distended is usually the time when transient LES relaxations take place.
Another factor that can contribute to acid reflux is a hiatal hernia. Many patients with a hiatal hernia also have GERD but as we said at the beginning this symptom is not always present with patients who suffer from acid reflux disease. Also there are quite a number of folk with a hiatus hernia who do not have GERD. It is not known for certain how Hiatal hernias develop although it may be through bouts of coughing, retching, or lifting heavy objects. It could also be a weakness in the muscles lining the stomach. Having a Hiatal hernia can reduce the pressure the LES exerts an allow stomach contents to reenter the esophagus. A hiatus hernia can also protrude through the diaphragm and distort the LES therefore allowing reflux to occur.
Another problem can be with the contractions of the esophageal muscles. We have already said that the food we eat is propelled to the stomach through the esophagus through muscle contractions. This action is called peristalsis. Sometimes this wave like tightening and relaxing of the esophageal muscles die out or are too weak for food to reach the stomach. This can reduce the clearance of acid contents from the esophagus and can be worse at night when lying in bed due to the effects of gravity. This inability to clear acid from the esophagus is found frequently in patients who suffer severe acid reflux.
One more problem is slow emptying of the stomach. Slower emptying of the stomach after a meal prolongs the distention of the stomach when reflux is more likely to occur.
Patients with acid reflux disease can suffer from any one or all of the problems mentioned. You should consult your doctor if you suspect you are suffering it and he will probably prescribe some form of acid reflux medication.
