Gastroesophageal reflux, or as some people might call it, takes place when the body’s lower esophageal sphincter (LES) does not close properly, causing stomach contents to be regurgitated up the esophagus. As the amount of gastric juices regurgitated into the esophagus goes over the normal limits, the result may be an injury to the mucous membranes of the esophagus, which is the typical symptom of gastroesophageal reflux disease (GERD). Of all people who have acid reflux, about half develop esophagitis.
Stomach acid reflux is as common among females as it is among males. It occurs in all age groups, but the incidence becomes greater among people who are over forty years old. Abnormal acid reflux can result from an irregularity in one or more of these protective mechanisms: relaxation of the LES, pressure of the LES, and intra-abdominal or intra-gastric pressure.
The common reasons for stomach acid reflux are either functional LES problems (i.e., frequent temporary LES relaxation) or mechanical LES problems linked to a hypotensive LES. Esophageal clearance is all about the neutralization of acid refluxed through the LES. Mechanical esophageal clearance occurs by means of peristalsis of the esophagus, and chemical esophageal clearance occurs by means of saliva.
Certain foods and beverages, such as coffee or alcohol, can diminish LES pressure. Drugs like calcium channel blockers, beta-blockers, and nitrates as well as hormones like progesterone may also have a similar effect.
Obesity is one of the contributing factors to stomach acid reflux, possibly because it can cause an increase of intra-abdominal pressure. Research has indicated that a high body mass index or BMI is a risk factor for acid reflux, although the mechanism through which high BMI can increase one’s exposure to esophageal acid does not seem fully understood yet.
Something that people with acid reflux should be aware of is that gastric reflux liquid is composed of not just acid but also duodenal contents such as pancreatic secretions and bile. Symptoms of stomach acid reflux that are non-esophageal in nature include coughing, as well as wheezing due to gastric contents aspirated into the trachea and bronchi or due to constriction of bronchial air passages that is caused by the vagal reflex arc. One more non-esophageal symptom is croakiness when the vocal cords have been irritated; this often happens to acid reflux sufferers in the morning.
Stomach acid reflux happens to be the most common source of noncardiac chest pain. Around half of such cases can be attributed to reflux. When health care providers have ruled out cardiac causes of chest pain, they usually try to rule out acid reflux, using esophageal manometry and 24-hour pH testing, although these tests are also said to be seldom useful in irrefutably establishing a diagnosis of GERD.