What causes Acid Reflux Disease?

 The acid that is produced in the stomach is called Hydrochloric Acid. Along with enzymes and other chemicals, this acid plays a very important role in the digestion of food in the stomach. The acid kills the harmful bacteria present in the food. On an average the stomach produces 2 liters of acid daily. The same acid, which plays such an important role in our daily lives, creates havoc when it enters the food pipe. 

No one knows why people get Acid Reflux, there are many probable causes of Acid Reflux and it can be triggered off in different people for many different reasons. Some people have a tendency to produce more acid than others, in some individuals the LES (or the valve that controls the movement of food from the food pipe into the stomach) muscles become weak, sometimes an episode can be triggered by smoking, eating citrus or spicy foods, or eating garlic and onions or fried and greasy things. Obesity and alcohol are also to be blamed for causing heartburn and burning. 

But research shows that there are three main contributing factors to Acid Reflux. The first is the functioning of the LES. The LES is the most active muscle in the esophagus tube. Whenever food or saliva is swallowed, the LES muscle relaxes for a few seconds to allow the food to pass into the stomach after which it closes again. Studies have shown that in Acid Reflux patients the functioning of the LES valve becomes abnormal. Sometimes the LES muscle becomes weak thereby reducing its ability to control reflux. In some other individuals, this muscle relaxes frequently on its own even when no food or water is being swallowed. It can happen several times in a day and lasts for a few minutes. During this time a lot of acid flows into the esophagus resulting in pain and discomfort. This happens most often after the patient has eaten a heavy meal that causes the stomach to bloat and distend. Some experts also say that in some Acid Reflux patients' digestion takes place very slowly. This means that the food stays longer in the stomach, which means that there is more time in which the LES can relax thereby increasing the chances of the acid flowing into the food pipe. 

Another contributory cause is thought to be hiatal hernia. A hiatal hernia occurs when the upper part of the stomach pushes above the diaphragm, the muscle wall that separates the stomach from the chest. As a result a small part of the stomach and LES now come to lie in the chest. The diaphragm that surrounds the LES keeps acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up. In this way, a hiatal hernia can cause reflux. A hiatal hernia can happen in people of any age; many otherwise healthy people over 50 have a small one. Even though hiatal hernias are seen in patients with Acid Reflux there is no direct correlation between the two. So you may have a hiatal hernia and yet not have Acid Reflux and vice versa. 

As mentioned earlier, the action of swallowing is a good way to counter acid reflux. When we swallow the action creates a wave like contraction in the food pipe, which pushes the food and saliva into the stomach. In patients with Acid Reflux it is very often noticed that the waves of contraction accompanying the swallowing action are not strong enough to push the food or anything else present in the pipe completely into the stomach. This becomes worse when the patient is asleep as the gravity too is not able to contain the acid. Doctors also say that smoking too reduces the chances of clearing the acid from the stomach. This affect can last upto 6 hours after smoking.