Food and drink passes through the esophagus to reach the stomach. The esophagus is a muscular tube and at its lower end, there is a muscle called the lower esophageal sphincter. If the stomach contents and stomach acid can pass backwards from the stomach, through the sphincter and into the esophagus, this is reflux. Spicy food can cause reflux because it makes the sphincter relax, and this allows food to pass back into the esophagus.
GERD
GERD stands for gastroesophageal reflux disease. It is a disease which develops because the contents of the stomach reflux backwards into the esophagus. Every year, Americans make approximately 9 million office visits to a physician because of this disorder, at a total cost for visits and treatment of over $9 billion, according to John Saltzman, M.D., Associate Professor of Medicine at Harvard Medical School in "Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy." Yet, GERD is on the rise.
Statistics
Reviewing the data involving 77,671 people, Paul Moayyedi, M.D. concludes in the August 2005 issue of "Alimentary Pharmacology and Therapeutics," that 25 percent of the people who live in Western countries have symptoms of GERD at least one time every month, 12 percent have symptoms at least once a week, while 5 percent have symptoms every day. Women have GERD just as much as men, and although it was not clear whether or not there is a relationship between GERD and age, the data showed that there is a relationship between obesity and GERD.
Risk Factors
There is a muscle between the esophagus and the stomach called the lower esophageal sphincter. If this muscle is too relaxed, even temporarily, it cannot stop the stomach contents and acid from refluxing, explains Dr. Saltzman in "Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy." The risk factors include any medication that relaxes smooth muscle. Pregnant women are at risk because the high levels of progesterone relax smooth muscle. Cigarettes, weight gain, eating before lying down, caffeine, fatty foods, peppermint, chocolate, carbonated beverages, alcohol, vinegar, tomato products, citrus fruits and spicy foods can also cause GERD.
Food and GERD
Weight gain and eating just before lying down are risk factors because they both increase the pressure in the stomach. In addition, when someone is lying down right after eating, the food is near the lower esophageal sphincter, writes Raj Goyal, M.D., Professor of Medicine at Harvard Medical School in "Harrison's Principles of Internal Medicine." Cigarette smoking, alcohol, vinegar, tomato products, citrus fruits and spicy foods can lower the pressure in the sphincter, which can make it relax. All of these food products are also acidic.
Treatment
In "The Merck Manual for Healthcare Professionals," the different types of treatment are explained by Michael DiMarino, M.D., Clinical Assistant Professor of Medicine at Thomas Jefferson University. People with GERD should not lay down until two to three hours after they eat and before lying down, they should raise the head of the bed approximately six inches. They should also avoid consuming the food and beverages mentioned above which can cause GERD or aggravate it, including spicy foods. Medication and surgery are available if needed.
References
- "Alimentary Pharmacology and Therapeutics"; Gastro-oesophageal reflux disease --- the extent of the problem; August 2005
- "Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy"; Norton Greenberger, M.D.; 2009
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
- The Merck Manual for Healthcare Professionals: Gastroesophageal Reflux Disease
