Heartburn or reflux disease often results from a dysfunction of the sphincterbetween the esophagus and the stomach. Normally, the so-called lower esophageal sphincter ensures that the stomach contents can not rise into the esophagus. Why he sometimes does not work properly, often remains unclear. However, several factors may favor reflux. These include, for example, alcohol and nicotine : they have a relaxing effect on the muscles – the sphincter between the esophagus and stomach also relaxes under the influence of beer, cigarette & Co. In addition, the two stimulants increase the production of stomach acid. Both mechanisms promote the occurrence of heartburn.
Also rich, fatty meals, chocolate, coffee, hot drinks, citrus juices and certain medications can contribute to reflux. Among the medications, for example, some antihypertensives and antibiotics, osteoporosis drugs (bisphosphonates) as well as painkillers and anti-inflammatories from the group of NSAIDs ( acetylsalicylic acid , ibuprofen , diclofenac, etc.) can cause heartburn.
Some sufferers also report that stress , anger or a certain posture (such as prevention) in them promotes the reflux. In addition, people with a strong overweightare particularly susceptible to heartburn . The body mass and an increased fat content in the abdomen increase the pressure prevailing in the stomach. So it can easily happen that stomach contents are “pressed” up into the esophagus.
An increase in pressure in the abdomen also occurs in pregnant women . Therefore, heartburn is also common in pregnancy .
In addition, various diseases can cause a reflux. These include, for example:
- Diaphragmatic fracture : Usually the esophagus passes through the diaphragm just before the stomach. In the case of the so-called hiatal hernia, however, the diaphragm has a hole. Part of the stomach pushes up through this hole and gets a little bit constricted. Thus gastric contents can be pushed high into the esophagus. The diaphragmatic hernia is often discovered by chance only when the patient visits the doctor due to frequent heartburn.
- Esophagitis : Esophagitis can be triggered by, among other things, swallowed foreign bodies (mucosal injury in the esophagus) or pathogens such as bacteria. The attacked, irritated mucous membrane can become noticeable with heartburn. Caution: Esophagitis may also be the result of reflux.
- Irritable stomach : The term irritable stomach (or “functional dyspepsia”) refers to various upper abdominal complaints for which no organic cause can be found.At the possible complaints include acid reflux and heartburn, among other pain, pressure and fullness in the upper abdomen, nausea and vomiting,and Loss of appetite .
- Gastritis : Gastritis may be caused by the bacterium Helicobacter pylori. Also irritants such as nicotine, coffee and alcohol as well as stress come as a cause in question. About the symptoms of the inflammation
- Esophageal wall protuberances: These esophageal diverticula may cause, among other things, belching and heartburn.
- Achalasia : This is a rare condition in which the contractility of muscles in the esophageal wall is weakened. The function of the sphincter at the stomach entrance is disturbed. The transport of food into the stomach is impaired, which manifests itself in, among other things, belching and heartburn.
- Diabetes : An advanced diabetes mellitus may affect the esophageal nerve control. Even with this disorder, the transport of chyme no longer works properly.