Approximately 25 million adult Americans have heartburn on a daily basis, and more than 60 million Americans suffer from heartburn at least once a month. Anyone can suffer from mild and occasional heartburn if they overeat acidic foods. This is especially true if they take a nap or bend over after eating a high fat, acidic meal. If they, however, suffer from chronic heartburn that occurs two or more times a week, they may have gastroesophageal reflux disease (GERD).
GERD can be due to various conditions, including abnormal biologic or structural factors. It is important that individuals who suffer from frequent heartburn consult with their physcians to find the cause of their acid reflux, and agree on a treatment plan.
Malfunction of the Lower Esophageal Sphincter (LES) Muscles
The band of muscle located at the junction between the esophagus and the stomach is called the lower esophageal sphincter (LES). This muscle is responsible for closing and opening the lower end of the esophagus and acts as a pressure barrier against the contents in the stomach. It is an area of smooth muscles and various hormones. If it is weak or loses tone, the LES will not close ompletely after food passes into the stomach. Stomach acid can then back up into the esophagus. Certain foods and beverages, drugs, and nervous system factors can weaken LES and impair its function.
Abnormalities in the Esophagus
There are some studies that suggest that most people with uncommon GERD symptoms may (such as hoarseness, feeling like there's a lump in the throat, chronic cough) have certain abnormalities in the esophagus that other GERD patients don't.
Impaired Stomach Function
One study has shown that over half of GERD patients showed abnormal nerve or muscle function in their stomachs. These abnormalities cause impaired motility. This occurs when the muscles in the stomach cannot act spontaneously. The muscles do not contract normally, which causes delays in the stomach's ability to empty. This can increase pressure in the stomach which, in turn, can increase the risk for stomach acid to back up into the esophagus.
Motility Abnormalities.
In normal digestion, food is moved through the digestive tract by rhythmic contractions called peristalsis. When someone suffers from a digestive motility abnormality, these contractions are abnormal. This abnormality can be due to one of two causes: A problem within the muscle itself, or a problem with the nerves or hormones that control the muscle's contractions. Problems in peristalsis in the esophagus are common in GERD, although it is this not clear if such occurrences are a cause or result of the long-term effects of GERD.
Hiatal Hernia
A hiatal hernia occurs when the upper part of the stomach pushes through an opening in the diaphragm, and up into the chest. This opening is called the esophageal hiatus or diaphragmatic hiatus. It is believed that a hiatal hernia can weaken the (LES) and cause reflux. However, studies have failed to prove that it is a common cause of GERD. A hiatal hernia, however, may increase GERD symptoms in patients with both conditions.
Other Gastrointestinal Condition Associated with GERD
Other disorders that may affect areas of the digestive system that can contribute to GERD include diabetes, any gastrointestinal disorder, peptic ulcers, lymphomas, and cancer.
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Part 1: Problems with the esophagus and stomach
Part 2: Other conditions that can cause GERD
