In daily life, gastroesophageal reflux is a common digestive disorder that causes a lot of discomfort and distress to patients. Why is this happening? What causes the reflux of food and acids in the stomach into the esophagus? This article will delve into this question and analyze it from four key aspects, hoping to solve this mystery for you and give you a clearer understanding of gastroesophageal reflux.
Esophageal sphincter dysfunction
The esophageal sphincter, a ring-shaped muscle that connects the esophagus to the stomach, controls the passage of food from the esophagus into the stomach. However, when the esophageal sphincter is dysfunctional, it can lead to the backflow of food and digestive juices from the stomach into the esophagus, causing gastroesophageal reflux.
1. Esophageal sphincter dystonia
Esophageal sphincter dystonia is one of the common causes of gastroesophageal reflux. Normally, the esophageal sphincter maintains some tension to prevent the reflux of stomach contents into the esophagus. However, when the tone of the esophageal sphincter weakens, it causes food and stomach acid to move upward, irritating the esophageal mucosa, causing discomfort and pain.
2. Excessive relaxation of the esophageal sphincter
In addition to hypotonia, excessive relaxation of the esophageal sphincter is also one of the important causes of gastroesophageal reflux. In this case, the esophageal sphincter loses its normal tightening effect and is unable to effectively prevent the reflux of fluid from the stomach into the esophagus, causing stomach acid to burn the esophageal mucosa, causing pain and discomfort.
Diaphragm dysfunction
The diaphragm is an important dividing line between the thoracic and abdominal cavities, and its function is not only for the movement of the muscles during breathing, but also for the proper functioning of the digestive system. However, when the diaphragm is dysfunctional, it may affect the occurrence of gastroesophageal reflux.
1. Diaphragmatic activity is weakened
Decreased diaphragmatic activity is one of the common causes of gastroesophageal reflux. Normally, the diaphragm exercises to help maintain pressure in the stomach and prevent the reflux of stomach contents into the esophagus. However, when diaphragm activity is weakened, it causes a drop in pressure in the stomach, making it easier for food and stomach acid to reflux into the esophagus, exacerbating the symptoms of gastroesophageal reflux.
2. Abnormal diaphragm position
In addition to decreased activity, abnormal diaphragmatic position may also contribute to the development of gastroesophageal reflux. In some cases, the position of the diaphragm may be altered by congenital or acquired conditions that prevent it from effectively isolating the stomach and esophagus, increasing the risk of reflux of gastric contents into the esophagus.
Abnormal esophageal motility
Decreased esophageal peristalsis
Esophageal peristalsis is a wavy contraction of the esophageal muscles that pushes food down through the esophagus to transport food from the throat to the stomach. When esophageal peristalsis weakens, the force of this wavy contraction weakens, causing food to stay in the esophagus for an increased amount of time. This condition makes food more likely to be regurgitated because it has more time to accumulate in the esophagus, increasing the likelihood of stomach contents refluxing into the esophagus.
Weakened esophageal motility can be caused by a variety of reasons, including neurological disorders, degeneration of esophageal muscles, and long-term use of certain medications. For example, some neurological disorders such as Parkinson's disease may affect the normal contraction of the esophageal muscles, resulting in weakened esophageal peristalsis. In addition, long-term use of some drugs that affect the nervous system, such as antidepressants and antipsychotics, may also affect the normal function of esophageal peristalsis.
Esophageal peristalsis is uncoordinated
In addition to decreased peristalsis, the incongruity of esophageal peristalsis is a common cause of gastroesophageal reflux. Coordination of esophageal peristalsis refers to the synchronicity of the wave-like contractions of the esophageal muscles in order to efficiently push food down to the stomach. However, when esophageal peristalsis becomes uncoordinated, the wavy contractions of the esophageal muscles may become chaotic, causing food to stagnate in the esophagus or regurgitate into the upper esophagus.
The incongruity of esophageal peristalsis can be caused by a variety of factors, including esophageal muscle lesions, neurological disorders, gastrointestinal surgery, etc. For example, esophageal muscle lesions such as hiatal hernia can cause uncoordinated esophageal peristalsis because this can interfere with the normal function of the esophageal muscles. In addition, some neurological disorders such as multiple sclerosis may also affect the coordination of esophageal muscles, resulting in uncoordinated esophageal movements.
Lower esophageal sphincter dysfunction
Loss of tone in the lower esophageal sphincter
The lower esophageal sphincter is a ring-shaped piece of musculature located at the junction of the esophagus and stomach, whose main function is to keep the esophagus and stomach tightly closed when not eating, to prevent the reflux of gastric contents into the esophagus. However, when the lower esophageal sphincter loses tone, it leads to a loss of this defensive function, making it easier for gastric contents to reflux through the esophagus.
Loss of tone in the lower esophageal sphincter can be caused by a variety of causes, including hiatal hernia, inflammation of the esophageal mucosa, long-term use of nonsteroidal anti-inflammatory drugs, etc. For example, a hiatal hernia is a common cause of loss of tone in the lower esophageal sphincter because it shifts the position of the lower esophageal sphincter, causing it to lose its normal closed function.
Excessive relaxation of the lower esophageal sphincter
Excessive relaxation of the lower esophageal sphincter is when the lower esophageal sphincter is in a state of excessive relaxation and is unable to effectively close the junction between the esophagus and the stomach. This condition can be caused by a variety of factors, including long-term gastroesophageal reflux, neurological disorders, abnormal gastroesophageal sphincter function, etc.
For example, long-term gastroesophageal reflux causes the lower esophageal sphincter to be stimulated by stomach acid and gradually lose its tone, leaving it in a state of excessive relaxation. In addition, some neurological disorders, such as diabetes, may also affect the normal function of the lower esophageal sphincter, causing it to relax excessively.