How Does Gastro-Oesophageal Reflux Develop?

When you eat, food is propelled from the mouth to the stomach through a tube called the oesophagus with the aid of sweeping oesophageal muscle contractions. At the lower end of the oesophagus is a specialised ring of muscle called the lower oesophageal sphincter (LOS).

The LOS remains tightly contracted until food or liquid arrives from above. The LOS relaxes, allowing the food and liquid to pass into the stomach and then re-tightens again acting as a one-way valve. This action prevents stomach acid, bile salts, and enzymes from flowing up into the oesophagus, causing symptoms and tissue damage. GORD occurs when the LOS relaxes abnormally or becomes weakened, stomach acid tends to back up, causing symptoms of heartburn. This can be exacerbated by the presence of a hiatal hernia.

What Contributes to Gastro-Oesophageal Reflux?
Some people are born with a naturally weak lower oesophageal sphincter (LOS). For others, however, fatty, spicy and tomato-based foods, certain types of medication, tight clothing, smoking, drinking chocolate, caffeinated beverages, citrus drinks, peppermint and alcohol, vigorous exercise or changes in body position (bending over or lying down during the first 3 hours after meals) and obesity may stress the anti-reflux mechanisms or cause the LOS to relax, causing reflux.