GERD or ‘Gastroesophageal Reflux Disease’ is a complex condition that occurs when acidic gastric juices from the stomach flow up into the esophagus repeatedly. This unusual reflux of acid back up into the esophagus causes irritation to the esophageal lining, further leading to a burning sensation in the lower chest. If acid reflux is not controlled, over a period of time the burning sensation can induce throat pain, nausea and other complications like esophageal stricture, bleeding, severe chest pains that can mimic a heart attack or a pre-cancerous change in the lining of the esophagus. There are multiple causes of the esophagus operating differently in different individuals or even in the same individual at different times. To have a better knowledge of what causes GERD, go through the following pointers.
Excessive Acid Production
Albeit rare, one of the major causes for GERD in some patients is an abnormally high production of acid in their bodies, far more than required. This leads to a reflux of the acid, and the degree of potency in such acid is unusually high, resulting in major damage.
Lower Esophageal Sphincter
Esophagus is the pipe like passage that connects your throat to the stomach. The meeting point of your stomach and esophagus is a ring of muscle known as ‘the lower esophageal sphincter’ (LES). The job of this sphincter is to act as a gateway from the esophagus to your stomach allowing the food which you consume to stay in your stomach in order to be converted into energy. However, when the lower esophageal sphincter does not perform properly, it can lead to GERD. There are two problems that can affect the functioning of the LES:
- The LES in a few of the GERD sufferers tends to get extremely weak. In other words, the lower esophagus does not contract and close the gateway between the stomach and esophagus properly, letting the acid reflux easily into the esophagus causing damage to its lining.
- Usually, the LES relaxes for a few seconds during normal swallowing to let the food and the liquid content pass down to the stomach. However, in some cases, the lower esophageal sphincter tends to relax randomly at odd times and not just while swallowing the food. This unusual relaxation of the LES can last from a few seconds to a few minutes, leaving the connecting passage wide open for the acid to reflux into the esophagus without any blockage.
Majority of GERD sufferers have hiatal hernias. In normal individuals the diaphragm surrounds the LES where it connects with the stomach. The diaphragm is said to help the LES contract in order to keep the gateway between the esophagus and the stomach closed every time except while chewing. However, if the patient is suffering from hiatal hernia, the ability of the diaphragm to help the LES to contract reduces. This decreased ability of the diaphragm leads to an easy flow of acids back up into the esophagus and damages it. Hiatal hernia can cause acid reflux problems in two more ways:
- A hiatal sac can get built in the event of hiatal hernia. When a person is suffering from hiatal hernia, a small portion of the upper stomach of that person tends to push its way past the LES, which pinches the part of the upper stomach from the rest of it, forming a sac like structure in which acid can get formulated over a period of time. This acid formed in the formulated sac waits for the LES to relax during which it can enter the esophagus, causing a burning sensation and damage.
- In a normal individual, the esophagus connects to the stomach at an angle where a flap of skin acts like a doorway to the stomach. This door works along with the LES and opens and closes during swallowing. But in a person suffering from hiatal hernia the angle at which the esophagus and stomach meet, gets altered, making the doorway ineffective, thereby causing a reflux of stomach acids into the esophagus.
As we all know, swallowing plays an important role in passing on food and other liquids from our mouth to our stomach. Swallowing also helps in getting rid of extra reflux from the esophagus. However, this process is not carried out normally by a patient of GERD. In the patient, the swallowing process gets irregular; in other words, the normal ability to push food from the top of the esophagus through to the stomach is not always possible in a GERD patient. This dysfunctional behavior of the esophagus also leads to the piling up of reflux acid that would have otherwise gone back down to the stomach.
Smoking and GERD
Smoking is another factor that can lead to GERD and risk of acid reflux. Smoking makes the esophageal sphincter relax at odd times, paving the way for the acid reflux to take place. Therefore, in order to get rid of the problem of GERD, patients are asked to give up smoking.
Weight As A Cause
Weight gain by a person can also lead to GERD and acid reflux problem. Therefore obese people and pregnant women are more prone to experience acid reflux. Increased weight puts extra pressure on the abdomen, thereby increasing the risk of esophageal reflux. The more obese or overweight a person, the more likely he/she are to be at risk of acid reflux and GERD issues.