The causes of GERD are complex and numerous. We all may experience symptoms of heartburn at times; however, persistent acid reflux is referred to as gastroesophageal reflux disease, or GERD. GERD may be accentuated as a result of the abnormally high production of acid, but the more common causes of GERD are related to anatomic or functional disorders of the esophagus or stomach. This would include lower esophageal sphincter abnormalities, hiatal hernias, abnormal esophageal clearance, and slow or prolonged emptying of the stomach. Most reflux symptoms occur after eating or in relation to body position. Read on to learn more about how this can lead to chronic reflux, or GERD.
Lower Esophageal Sphincter: The proper functioning of the lower esophageal sphincter (LES) is the most important component in preventing reflux. The lower esophageal sphincter is a ring-like muscle at the end of the esophagus connecting it to the stomach. This is a very active muscle allowing the passage of contents in the esophagus to pass through to the stomach by relaxing upon swallowing but quickly tightening to restrict the reflux of any acid or bile back into the esophagus. Abnormalities in the functioning of this muscle can lead to GERD.
Hiatal Hernia: A large majority of patients with GERD also have hiatal hernias. This is because the hernia creates a distortion and disfunction of the LES and may also restrict emptying of the herniated portion of stomach. A hiatal hernia occurs when the stomach moves up into the chest through the opening in the diaphragm. All patients with reflux do not have hiatal hernias and not all hiatal hernias require surgical repair. Some larger hiatal hernia can cause other symptoms of chest discomfort after eating or difficulty swallowing.
Esophageal Clearance: The swallowing mechanism is essential in clearing fluid from the esophagus. Ring-like waves of coordinated contractions are set off within the esophageal muscles, referred to as peristalsis. This pushes food, saliva into the stomach and helps to prevent stomach contents from remaining in the esophagus after a reflux episode. When the esophageal muscles do not contract as they should, contents such as acid can be left in esophagus causing symptoms of GERD.
Slow Emptying of the Stomach: Abnormalities of the stomach can also predispose someone to reflux and include poor emptying, dilation, increased stomach pressure, and overproduction of acid
If you have heartburn or GERD symptoms despite lifestyle changes, dietary changes, and medication therapy, antireflux surgery might be considered in treating your symptoms. For more information on treatment options and the physicians at Premier Surgical Associates, visit our website.