Normally, after swallowing, a valve between the esophagus and stomach opens to allow food to pass. It then closes to prevent stomach contents from refluxing into the esophagus. This valve is made up of muscle called the lower esophageal sphincter (LES). When it fails to close immediately after swallowing, stomach acids can flow back into the esophagus, causing irritation and burning also called heartburn.
What Causes Heartburn and GERD?
There are many reasons why this muscle loses its tone and ability to close. They include: nicotine from cigarette smoke, caffeine, certain medications, viruses and others causes. Reflux itself can lead to damage, further interfering with the muscle’s ability to contract and close off the lower esophagus.
Other potential causes of GERD:
If there is a scar at the outlet of the stomach from previous ulcer disease, there can be resistance to the stomach emptying, leading to over-distention of the stomach and reflux.
Diseases such as diabetes can lead to poor muscle function of the stomach, poor emptying, and then ultimately reflux.
Overeating at times can stretch out the stomach making it more vulnerable to reflux.
Hiatal Hernias - many people with significant reflux have a hiatal hernia. This is where the esophagus passes through the muscle of the diaphragm. If there is a weakness where the esophagus enters the diaphragm, a hole can form in the muscle and part of the stomach can rise up through the chest cavity. This is a hiatal hernia. Being obese raises the risk for hiatal hernia. Additional weight increases the pressure in the abdomen, pushing its contents against the diaphragm.
Lifestyle Factors That Can Make GERD Worse
Eating spicy, acidic or fatty foods. These include, but are not limited to onions, tomato sauce, mint and chocolate.
Drinking caffeinated or alcoholic beverages
Eating large meals
Lying down after eating
Medical Conditions That Can Make GERD Worse
Connective tissue disorder
Delayed stomach emptying
Smoking and GERD Believe it or not, smoking can be a culprit when it comes to reflux in several different ways. How, you ask? Smoking lowers the pressure of the lower esophageal sphincter, increases the stomach’s production of acid and reduces the amount of saliva produced. Saliva helps clear acid from the esophagus. If smoking is a contributing factor to your reflux, know that Akron General offers help to quit smoking. Visit our listing of Classes & Events to learn more.
Do Medications Cause GERD? Rarely, medications can provoke reflux. These include blood pressure medications and calcium channel blockers, especially Nifedipine (Procardia). These can lower the esophageal sphincter pressure, promoting reflux in some patients. Usually, however, foods and beverages, such as caffeine, peppermint and chocolate bring on an attack.