What Causes GERD & Acid Reflux?
What To Look For And What To Expect
What Causes GERD and Acid Reflux?
Compared to the relatively simple definition of what GERD is, what causes GERD is much more complicated. For the sake of providing you with a good working idea of the causes of GERD without boring you to tears, we’ve provided you with a thumbnail sketch of each of the main causes of GERD. For more information about any of these causes, we suggest you consult your primary care physician.
1. Excess Production of Acid.
Believe it or not, only a small percentage of GERD sufferers are afflicted with the disease because their bodies produce an abnormally high amount of acid. Although it is a small segment of the GERD population, excess acid production can be a cause of the disease. In this instance, a sufferer simply produces more acid than the body knows what to do with and the refluxed acid has an unusually high degree of potency and can cause damage.
2. Lower Esophageal Sphincter
As you know the esophagus connects your throat to your stomach. Where your esophagus and stomach meet, a ring of muscle, called the lower esophageal sphincter, serves as a connector. Typically, the muscle is constricted so the contents of the stomach stay exactly where you want them to—in the stomach. However, when you are eating, the muscle relaxes momentarily to allow your food and liquids to make their way from the esophagus to the stomach. Basically, the lower esophageal sphincter acts as the gateway from your esophagus to your stomach.
3. Weak Muscle Contraction
However, for many GERD sufferers the lower esophageal sphincter is not performing its job correctly. Typically, there are two problems with lower esophageal sphincter that can cause GERD.
Weak muscle contraction. The lower esophageal sphincter in some GERD sufferers is extremely weak. In other words, it just doesn’t close off the gateway between the stomach and the esophagus effectively. This “partially open door” allows acid to reflux more readily into the esophagus and cause damage.
Transient lower esophageal sphincter relaxations—Don’t worry; it’s not as complicated as it may sound. During normal swallowing, your lower esophageal sphincter relaxes for a few seconds to allow your food and liquids to pass through. However, in some GERD sufferers, the lower esophageal sphincter will relax at random times and not during eating. These “relaxations” also last for up to several minutes. During this time, the “gate” is wide open and acid can reflux into the esophagus unobstructed.
4. Hiatal Hernias.
The ways in which hiatal hernias contribute to GERD is not entirely clear. However, a majority of GERD sufferers have hiatal hernias. At this point, you might be asking yourself, “What is a hiatal hernia?” That’s a great question.
In normal individuals, the diaphragm surrounds the lower esophageal sphincter where it connects with the stomach. For GERD sufferers, a small part of the upper stomach—the esophageal sphincter and the diaphragm.
If you’re wondering how this condition causes GERD, you’ve asked another great question. At its most basic, the diaphragm is thought to help the lower esophageal sphincter contract and keep the gateway between the esophagus and the stomach closed during all times except swallowing.
When a hiatal hernia presents itself, the ability of the diaphragm to help the lower esophageal sphincter is seriously compromised. As a result reflux can be greatened and acid can do its damage in the esophagus.
There are two additional ways that a hiatal hernia can cause reflux problems:
Hiatal Sac. In the event of a hiatal hernia, a small portion of the upper stomach pushes its way past the lower esophageal sphincter. Because the lower esophageal sphincter is a muscle, it effectively pinches off this part of the stomach from the rest of the stomach. In this “sac” acid can build up. The built up acid is ready and waiting for the lower esophageal sphincter to relax at which time the reflux can easily re-enter the esophagus.
“Broken Door.” In normal individuals, the esophagus connects at angle to the stomach. At the place where they connect, a flap of skin serves like a doorway to the stomach. In normal functioning, the door works with the lower esophageal sphincter and opens during swallowing and closes afterwards to prevent reflux. However, with a hiatal hernia, the angle at which the stomach and esophagus connect is altered and the doorway can become ineffective. No longer able to keep a good seal between the stomach and the esophagus, reflux can work its way back into the esophagus.
5. Esophageal Contractions
As we’ve seen, swallowing plays an important part in getting your food and liquids from your mouth to your stomach. In addition, we’ve seen how swallowing can help rid the esophagus of extra reflux. However, many GERD sufferers experience irregular swallowing abilities.
In other words, the regular ability to push food from the top of the esophagus through to the stomach is not always possible for GERD sufferers. The inability of the esophagus to work as it should allows build up of reflux that would otherwise be pushed back down into the stomach. The excess reflux can then lead to esophageal problems.
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