Reflux
Reflux means a backflow of liquid in the body. Most commonly it is used for the backflow of contents from the stomach into the oesophagus, usually occasioned by a weak or malfunctioning Lower Oesophageal Sphincter (LOS). This is known as Gastro-Oesophageal Reflux (GOR) and if it persists it is called Gastro-Oesophageal Reflux Disorder (or sometimes Disease) - GORD for short.
Gastro-oesophageal reflux
The LOS works with the muscles of the crural diaphragm (at the base of the ribcage and used in breathing) to hold the oesophagus shut most of the time. However, when our bodies are in an upright position, occasional transient relaxation of the muscles is permitted to release gas - as a burp or belch.
For many people, the Lower Oesophageal Spincter doesn't work as well as it should permitting stomach contents to flow back into the oesophagus.
Hiatus Hernia
One of the most common reasons for reflux is a hiatus hernia. The hiatus is the hole in the diaphragm the oesophagus passes through just above its junction with the stomach. In many people, the top of the stomach can push up through this hole. Known as a hiatus hernia, we don't always know why this happens. Some people may have been born with a larger hiatus enabling herniation to occur at a young age. For others, the upward pressure caused by excess body fat may be the contributing factor.
For most people a hiatus hernia will cause no problems but for others, their sphincter muscles may not be strong enough to keep the end of the oesophagus tightly closed.
Excess body weight and abdominal fat can put pressure on the stomach pushing the contents back up the oesophagus, but even fit, normal weight people can experience reflux. Amongst other causes may be tight clothing, vigorous exercise after food or simply bending over. If the LOS isn't functioning properly, stomach contents may be forced back through it.
There are some temporary fixes for a Hiatus Hernias, but these are not recommended as they will stretch the hiatus and make reherniation more likely.
These are
Some chiropractors will manipulate the stomach back down at a price.
There are some YouTube videos that show how you may try this yourself.
By filling your stomach with a lot of water to make it heavy, and stepping or jumping heavily down from a high step, the jolt may pull the stomach back down.
This is the burning sensation beneath the breatsbone, is the symptom most commonly associated with acid reflux but 30% of those with acid reflux report not having experienced it for some reason. (Statistic verified from a quick poll of members of the BarrettsEsophagusAwareness Facebook group January 2023.) The pain is from the acid attacking the mucosal layer of the oesophagus. It may be those who don't experience the pain are less susceptible to pain, the mucous dilutes the acid sufficiently for it not to burn ar their cells may have become desensitised by transformation (e.g. from squamous to columnar as occurs with Barrett's Oesophagus). Prolonged acid attack can cause scarring and inflammation called oesophagitis. Another possible reason is the protection afforded by oestrogen.
The term Gastro-Oesophageal Reflux Disease (GORD) may be used when someone experiences reflux symptoms frequently.
The term, Non-Erosive Reflux Disorder (NERD) may be used when someone has GORD but without acid.
Other symptoms that can be attributable to GORD
Refluxate can continue like a mist up the full column of the oesophagus whence it may breach the Upper Oesophageal Sphincter, too and aspirate into the respiratory system causing many other possible symptoms affecting lungs, throat, mouth, nose, ears and eyes. as described in the chapter on Extra Oesophageal Reflux
Vagal Nerve transference may be responsible for other pains caused from reflux:
Alongside the oesophagus as it passes through the hiatus hole in the diaphragm, lies the vagus nerve. If the oesophagus spasms or tightens in an attempt to reduce reflux, it can send messages via the vagus nerve that appear to originate anywhere in the upper body.
Page updated 18 January 2023