Gastroesophageal reflux disease occurs when the lower esophageal sphincter, or LES, muscle does not close properly. This allows stomach content to back up into the esophagus, causing burning pain in the chest and throat. GERD can lead to serious problems such as cancer of the esophagus and difficulty swallowing. According to the Society of Thoracic Surgeons, factors that prevent proper closing of the LES contribute to GERD.
Hiatal Hernia
According to the National Institute of Diabetes and Digestive and Kidney Disease, GERD is more likely in people with a hiatal hernia, which occurs when the upper part of the stomach and the LES move above the diaphragm into the chest cavity. Normally, the diaphragm helps keep the LES closed, but when a hiatal hernia is present, reflux is more likely because the LES remains open.
Weak LES
According to STS, people with GERD usually have an abnormal-functioning LES. Normally, the LES opens for a few seconds during swallowing. When the LES is weak, it stays open for a long time, causing frequent reflux of stomach content into the esophagus. Certain foods, disease and medications can contribute to the weakness of the LES. Foods such as chocolate, peppermint, coffee and high fatty foods make the LES weak. Spicy foods, citrus foods and tomato products also irritate the LES and make it weak. Connective tissue disorders such as scleroderma weaken the LES and other esophageal muscles leading to GERD
Delayed Gastric Emptying
According to STS, stomach contents are more likely to reflux into the esophagus if they stay in the stomach for too long. Gastroparesis is another name for delayed gastric emptying. One cause of gastroparesis is uncontrolled diabetes. Diabetes damages the vagus nerve, a nerve that controls movement of food from the stomach, and this leads to delayed gastric emptying.
Pregnancy and Obesity
According to STS, hormonal changes during pregnancy cause the lower esophageal sphincter not to close properly. Increased abdominal pressure from the growing fetus also causes GERD. Obesity causes increased abdominal pressure, which leads to GERD.
