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What are the causes behind GERD?

GERD takes place when the muscles in the lower part of the esophagus do not function as they should. One of these muscles is known as lower esophageal sphincter (or LES). This muscle is shaped like a ring and is used to close up the entrance of the esophagus to the stomach. Here are some facts about LES that will help you understand its role in the development of GERD

• LES, like any sphincter works as a valve that seals off the esophagus from the stomach. When it's relaxed and open, it allows the food to enter the stomach for digestion. When it's contracted and closed, it doesn't allow any food from entering the stomach as well as any substance from refluxing back into the esophagus from the stomach.
• When LES functions properly, the muscle is contracted right after the food has entered the stomach, preventing any reflux of acid and digestive enzymes into the esophagus, which in turn may damage it.
• Those who suffer from GERD usually have a dysfunctional LES, which either doesn't close right after the food has entered the stomach or can't relax properly when the food is in the esophagus. This causes some of the stomach contents to reflux into esophagus, which leads to severe damage, because stomach contents are rich with potent acid and digestive enzymes that are harmful to the surface of the esophagus. This contributes to the development of the unpleasant symptoms associated with GERD.

GERD and Hiatal Hernia

Hiatal hernia is a health condition, which is described by a part of the stomach being bulged up into the chest through the esophagus. This condition can develop throughout the life of the patient or be present right from the birth. When speaking about this condition, doctors distinct two ways hiatal hernia can cause the development of GERD:

• LES is usually wrapped with the diaphragm muscles, which often help the esophagus to close and prevent the reflux of the stomach contents. When hiatal hernia takes place, LES is placed above the diaphragm muscles in the chest cavity and this the muscles can't interact for closing the esophagus completely. Thus, the LES can't contract completely and allows the contents of the stomach to flow up into the esophagus, which is characteristic for GERD.
• The esophagus is usually connected with the stomach forming a sharp angle. The tissue in the point where esophagus and stomach are connected is bent into an additional valve of the stomach. This bend can prevent the acid from refluxing into the esophagus when the stomach is full. People with hiatal hernia have a less sharp angle of this bend and it's not enough to keep the esophagus protected from the stomach contents.