Reflux disease affects almost 60 million Americans each month, with one quarter of the population experiencing symptoms of this disease weekly. Often referred to as acid reflux, heartburn, indigestion, or dyspepsia, gastroesophageal reflux disease (GERD) ranges in severity from a mild inconvenience for millions of people to a severe and debilitating condition for chronic sufferers.
In normal individuals, a ring of muscle called the lower esophageal sphincter (LES) forms a one-way valve between the esophagus and the stomach, preventing stomach contents from flowing back into the esophagus. Failure of the LES allows corrosive liquid from the stomach to leak back into esophagus, which has no protection against it. The backward movement of stomach contents is called reflux. Over time, the acid and digestive juices in the stomach contents cause irritation and damage to the esophagus wall and are responsible for the familiar burning pain that most people experience as heartburn.
For most people, periodic heartburn is little more than an inconvenience and they are able to control it with lifestyle changes or over-the-counter medications. However, chronic gastroesophageal reflux disease is a serious condition in which prolonged exposure of the esophagus to stomach acids causes debilitating symptoms and may lead to conditions such as ulceration, strictures, esophagitis, Barrett’s esophagus, and in rare cases, cancer.
Causes of Reflux Disease
There are several factors that can combine to increase the likelihood that you will suffer from acid reflux or that will increase the severity of your symptoms:
Increased stomach pressure: This may be overeating or from conditions that alter stomach contractions and emptying.
Acidic Foods: Some foods increase the acidity or the amount of acid produced by the stomach. These foods include alcohol, acidic juices, tomato products, peppermints, chocolate, and soda.
Medications: Certain medications can affect stomach acid production and gastric motility or can interfere with the normal opening and closing of the LES.
Smoking: Makes reflux worse and causes peptic ulcers, esophagitis, and gastritis.
Hiatal Hernia: A hiatal or diaphragmatic hernia often accompanies gastroesophageal disease. The region of the muscular diaphragm through which the esophagus passes may enlarge and allow part of the stomach to move up through it. This alters the pressure at the end of the esophagus and allows reflux to occur.
Obesity: Stomach pressure increases with abdominal girth. As stomach pressure increases, it becomes more difficult for the LES to prevent reflux.
Nerve and Muscle abnormalities: Opening and closing of the LES relies on normal muscular function and nerve conduction.