When GERD Disease occurs
You probably are wondering why you have GERD disease. It is impossible to be precisely certain why you have this disease that is driving your symptoms. However, GERD disease is mostly found in westernized countries, particularly in North America and Europe. GERD occurs when the valve between the stomach and esophagus is unable to generate adequate pressure to function as an effective barrier. Once the LES (Lower Esophageal Sphincter) begins to degrade, stomach contents are able to reflux back up into the esophagus creating the disease.
So the real questions we should be asking are these:
- What has caused my LES to become nonfunctional?
- Why is GERD disease so common in the western world?
Our diet is the primary culprit
Both questions share a common answer: the primary underlying reason is that we overeat! In many parts of the world most people “eat to live”. In the western world we “live to eat”. Portion size has dramatically increased and the quality of food is so good we crave more and more. Most people love the typical American meal – double cheeseburgers and super sized fries. Typical GERD suffers have become addicted to gaining satisfaction from a meal only if they feel full. Therein lies the problem.
What happens when we overeat
When we eat more than a “comfortable” or appropriate amount of food for the stomach to handle, the stomach must stretch or distend to accommodate this additional volume. When this stretching happens, the lower end if the esophagus, where the LES is located, distends to a shape that actually resembles the horn end of a trumpet. In this situation, the lower part of the LES becomes exposed to stomach acid and damage to the esophagus is possible. The stomach lining can accommodate acid that it normally produces for digestion. The esophagus, however, including the LES, cannot handle highly acidic food and solutions routinely.
Overeating on a limited and intermittent basis is typically not a problem. Under these circumstances, minimal irritation of the lower esophagus and LES results and the esophagus heals itself. However, repeated and significant overeating, as is common in today’s western lifestyle, can damage the LES and cause it to lose its strength. Once the barrier is lost, acid reflux occurs initiating GERD disease. Scientific research has validated this connection, please read How excess weight is destroying your lower esophageal sphincter (and driving your GERD symptoms.
How the LES functions as a barrier
The LES has two properties that enable it to function as a barrier. They are the length of the LES and the pressure by which it “squeezes” the lower esophagus closed. If the lower LES is chronically exposed to acid by stomach distension from overeating, it becomes damaged to the point where it cannot generate pressure. So BOTH the length of the LES is lost and its ability to generate pressure declines. As the barrier is damaged, mild reflux may be intermittent. However, over time frequent reflux results in a significant reduction of both the LES’s length and its pressure. At some point, the LES’s barrier function is not just reduced, but is essentially gone.
The obesity epidemic in the United States creates a severely problematic situation. Obesity results from overeating so that the scenario described above is bound to occur. The LES function is first compromised by the increase pressure caused by large meals. Then, excessive pressure in the stomach is created by the very heavy abdominal wall “compressing” it. In fact, obese people are three times more likely to have frequent GERD disease than the non-obese.
The top recommendation to reduce the risk of GERD disease
Your GERD symptoms are a message from your body telling you something is wrong. Unless you take control of your illness and manage your disease, the messages may become more frequent and more intense and serious complications can result. Read about how GERD progresses or learn your reflux disease stage for personalized suggestions for taking control of your reflux disease, including the 5 steps to an effective acid reflux diet. If your body mass index (BMI) is under 27, then we recommend you follow RefluxMD’s GERD-friendly meal plan, Recipe for Relief. However, if your BMI is 27 or higher, you should consider a more rapid weight loss program as presented in Scale Down for Relief. For those with early stage GERD disease, maintaining a healthy BMI is the top recommendation by experts for symptom relief and to reduce the risk of disease progression. Get started today!
Reviewed by: Dr. Dengler, RefluxMD Medical Director