Health Conditions

GERD occurs when the muscular valve between the esophagus and the stomach does not function properly and acid backs up into the esophagus, damaging the mucosal lining of the esophagus.

The esophagus propels food toward the stomach by a rhythmic motion called peristalsis, which prevents acid-reflux by limiting the potential for the contents of the stomach to move upwards. A movement called secondary peristalsis clears the esophagus of any stomach contents that may be refluxed. The lower esophageal sphincter (LES) is a thick circular ring of smooth muscle at the bottom of esophagus. The LES relaxes before the esophagus contracts, and allows food to pass through to the stomach. After food passes into the stomach, the LES constricts, to prevent the contents from regurgitating into the esophagus.

After a meal, the LES usually remains closed. When it relaxes, it may allow acid and food particles to reflux into the esophagus. In experiments on patients with GERD, investigators found that when the stomach expands, the number of short LES relaxations increases. It is believed that these short periods of LES relaxation are the main cause of reflux episodes. As the number of LES relaxations increases, the frequency of reflux episodes increases. This increases the amount of time gastric acid spends in the esophagus, resulting in more irritation of the tissue.

Another factor that increases esophageal acid exposure time in patients with GERD is the ability of the esophagus to move food down into the stomach decreases. This happens because the esophagus is not producing strong enough secondary peristaltic movements.

Most episodes of GERD occur during the day, usually after eating, however, some sufferers also experience reflux during sleep. Nocturnal reflux is commonly associated with a higher risk and a higher degree of esophagitis. This is because acid remains in the esophagus for prolonged periods as a result of less swallowing and less saliva produced to neutralize the acid.

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Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.