Exactly What Causes Intense Heartburn Symptoms

Exactly What Causes Intense Heartburn Symptoms

The primary physiological cause of acid reflux is a lower esophageal sphincter valve that doesn't work in the way it was meant to - it tends to stay open longer than it should or it closes and opens at the wrong time. The normal tight muscle control of the opening and closing of this valve can be lost due to several factors, including transient muscle relaxations and a hiatus hernia.

Primary Causes of Acid Reflux

Weak lower esophageal sphincter (LES) muscle that does not maintain normal muscle tone and cannot provide a tight barrier between the esophagus and stomach.

Transient LES relaxations (TLESRs) that are inappropriate - not "triggered" by swallowing and different from the typical contraction and relaxation of the LES muscle.

Hiatus hernia that interferes with the normal functioning of the anti-reflux barrier, reducing the effectiveness of the complex interaction between the LES muscle, the diaphragm, and the fibrous tissue ligament that keeps the LES in its place at the "hiatus" in the diaphragm.

LES Muscle Weakness

A defect in the basal LES pressure is thought to be a primary problem that explains gastro esophageal reflux. When the digestive system is working normally, the muscles in the esophagus enable the movement of food through the system.

They tightly control the opening and closing of the lower esophageal sphincter valve, with assistance from key nerves located in the region of the stomach and LES, regulating the backward movement, or reflux, of acid, digestive juices, and gas. In a weakened state, this muscle may cause significant problems, resulting in inadequate regulation of the digestive system.

A weakening of the muscle action of the LES increases the risk of recurrent acid reflux problems as a result of acid and digestive juices refluxing into the esophagus and not being returned into the stomach. These fluids can be very irritating to the tissue of the esophagus, causing the burning pain of heartburn and the sour taste of acid in the throat.

Transient LES Relaxations

The LES muscle can be weakened by transient relaxations (TLESRs). Transient relaxations of the LES are continually occurring within the digestive tract, instigated by the act of swallowing. However, these relaxations are sometimes inappropriate or poorly timed. Unlike its role in triggering "appropriate" LES relaxations, swallowing sometimes does not trigger the transient relaxations of the LES. As a result, the LES opens and closes at the wrong time in the digestive process.

While it is not clear how these inappropriate transient relaxations are triggered within the body, they may be related to the quantity and kind of food we eat. The association of transient relaxations with acid reflux symptoms is increased after eating meals and while lying down. Interestingly, a large proportion of the population with acid reflux problems describe their symptoms as most obvious after meals, while some experience heartburn and reflux during the night while trying to sleep. Transient relaxations of the LES valve seem to explain the key symptoms of gastro esophageal reflux.

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