What causes gastro-oesophageal reflux disease or chronic “heartburn”?
It is still unclear why some people suffer from chronic heartburn more than others. Normally the lower gullet sphincter (valve) opens spontaneously for varying periods of the day leading to acid reflux which is not considered troublesome. However, studies do suggest that there are some structural abnormalities present in people with chronic heartburn or GORD that weakens the lower gullet valve (sphincter) keeping it open longer than usual while the rest of the gullet continues to work leading to excessive and troublesome acid reflux. Some of these structural abnormalities may include sliding hiatus hernia which occurs when the upper part of the stomach and the lower oesophageal sphincter move through an opening (hiatus) in the muscle that separates the stomach from the chest known as the diaphragm. The diaphragm normally helps the lower oesophageal sphincter with the overall mechanism that stops acid from backing up into the gullet. The presence of hiatus hernia does not automatically
