The Main Causes of Acid Reflux (GERD)
The causes of GERD (acid reflux disease) are frequently not straightforward to diagnose. In many cases, there may be not just one but several causes contributing to the problem. Some patients suffer from over-production of stomach acid, although this is not found so often. Actually, the main factors which can cause GERD are to be found in the strength (or rather, weakness) of the muscles of the lower oesophagus (lower oesophageal sphincter), efficient emptying of the stomach, defective oesophageal contractions and hiatal hernias, which can also cause reflux.
The most crucial part of your body's mechanism for stopping is the lower oesophageal sphincter, or LES. It controls the passage between the oesophagus and the stomach, opening to let food enter whilst closing primarily to block reflux. Consequently, if this muscle is weakened it can lead to increased reflux. This weakening can be the result of a more complex medical complaint, and can be classified in two distinct categories: weakened contractions and abnormal relaxations.
With weakened contractions, the LES simply does not do enough to prevent reflux from occurring, staying open for a considerable period and not just accompanying the swallow. Extended periods of relaxation allow reflux to flow back into the oesophagus. This is frequently the result of weakened oesophageal muscles.
Another contributory factor to reflux is the hiatal hernias, and most GERD patients will suffer from these problems. Nobody really knows why these hernias develop in GERD patients, but their effects are almost fully understood.
Basically what happens is this; when a hiatal hernia is present, part of the stomach has pushed up into the diaphragm, the muscular sheet which divides the abdomen from the chest. The diaphragm is a key factor in preventing reflux and works with the LES to ensure any reflux is kept to a minimum.
In patients with the hernia, this process is lessened because of the hernia's effect on the diaphragm, leading to increased reflux. What's more, the fact that a portion of the stomach is pushed into the diaphragm means that it is ideally suited to trapping acid, which can again lead to resulting in higher volumes of acid remaining close to the lining of the oesophagus.
At this stage we should note that the contraction of the oesophagus is vital part of the digestive process. This contraction forces food down towards the stomach, where the major process of digestion can begin. Patients with GERD sometimes find that the root of their problem lies in defective contractions of the oesophagus, which not only do not transport the food down to the stomach efficiently, but also fail to push reflux back towards the stomach as well. This could be to do with the weakened pressure of the muscular contractions, or might have developed as a result of smoking which tends to trap acid within the oesophagus for up to five to six hours.
So you can see that there can be many different causes of this uncomfortable condition, some more serious than others. Because of the acidic nature of the complaint, patients will often feel a burning sensation, and may not realize the true reasons why they are feeling this discomfort. To be on the safe side, it is best to consult your doctor, who will be able to give you a more accurate idea as to the precise cause of your reflux, and will be better placed to offer a diagnosis and effective course of treatment.
