So what causes acid reflux – This is the $64 m dollar question. If only I knew. Or the doctors knew. Or anyone who writes about it on the internet knew.
Acid reflux occurs when the valve at the top of the stomach, the lower esophageal sphincter (LES) allows acid to move from the stomach into the more sensitive esophagus. The causes can include obesity, hiatal hernia, certain foods and medicines.
Everyone is so concerned to tell you what they THINK causes it, and you’ve no doubt seen endless references to lists of so called “trigger foods”, to “trigger diets”, to physical causes such as obesity, hiatial hernia and even a tight waistband.
The truth is that there is no one cause, and that everyone who has the condition probably has their own individual reason why it happens. This means that each one of us has to find our own cause and remedy, recognising that there are common factors which can be usefully shared.
What Causes Acid Reflux?
The main culprit, whatever the underlying reasons, is the Lower Esophageal Sphincter (LES), which lies at the bottom of the esophagus (the “tube” through which food is transferred from the mouth to the stomach) and which acts as a door into the stomach.
Acid reflux occurs when this door allows acid to leak out of the stomach into the esophagus, where the highly corrosive hydrochloric acid, generated by the stomach to break down food, burns the sensitive esophageal lining.
Normally, this door only opens briefly to allow food into the stomach, but in cases of heartburn/acid reflux, it seems to open at other times and for sufficient periods so that acid leaks back up the esophagus.
However, whilst this may be the primary cause of acid reflux, there appear to many reasons why the LES acts in this way. For example, an article on Foxnews.com, quotes an authoritative assistant professor of medicine as saying that there are 7 causes of acid reflux. These are
1. Low Sphincter Pressure
3. Hiatal hernia
4.Gastroparesis (a disorder in which the stomach takes too long to empty its contents)
6. Bisphosphonates (This class of drugs prevents and treats osteoporosis in women and, occasionally, cause acid reflux in users)
7. Lifestyle – reactions to certain types of food and drink, smoking.
This article can be found here .
Other sources put more emphasis on lifestyle causes, including smoking and drinking (both of which are said to cause a relaxation of the LES). Types of food ( peppermint, tomatoes, chocolate, spicy foods, hot drinks, coffee, wheat, high carbohydrate intake seem to be common quoted “trigger” foods. In fact, the low carb diet as a “cure” for acid reflux has a significant fan club, and I’ll write about this elsewhere.) The size of meals is also up there as a protoganist – one source I read said that meals should be no bigger than your fist.
This all sounds as though it’s based on trials and experiments involving sufferers, but it isn’t (well not that I can trace), and is as useful as suggesting that all sufferers should try eliminating everything (not all at the same time, or you may find you have a more drastic problem than acid reflux). The only thing we can do is to experiment as systematically as we can, eliminating possible causes one by one.
One cause which seems to have a small, but solid following is low stomach acid. This sounds contrary to common sense, but there is a body of evidence which suggests that in some people this is a problem, and a root cause of acid reflux. Read more about this here.