Why the Sphincter Valve Weakens and How to Fix it.
The primary cause of Gastro-oesophageal Reflux Disease (GERD) is a weakened or damaged lower oesophageal sphincter (LES) muscle. While we cannot always understand why the sphincter muscle weakens, people at risk for GERD can take steps to care for their LES.
Here’s everything you need to know about why the sphincter muscle weakens and how you can reduce the risk of it becoming damaged.
What Is The Lower Esophageal Sphincter?
To prevent damage to the lower oesophageal sphincter, it’s essential to understand how it functions. The lower oesophageal sphincter (LES) is the muscle that connects the oesophagus (food pipe) to the stomach. This muscle remains closed the majority of the time, only opening to let food through to the stomach or to regurgitate stomach gas.
If a person’s LES is weak or damaged, the muscle can lose its ability to close, as happens in GERD, or its ability to open, as happens in a condition called Achalasia. When the LES fails to close, it allows stomach acid to splash up from the stomach into the oesophagus, causing acid reflux and heartburn. When the LES does not function properly, whether too lax or too tight, it can seriously disrupt normal digestion.
Why Does The Sphincter Valve Weaken?
There are different reasons why the LES muscle weakens, and most of these reasons are preventable. Here are a few of the preventable factors that lead to a weak LES.
1. Overeating or Overweight
When a person regularly overeats or is overweight, their stomach swells and puts extra pressure on the LES. Over time, the LES can lose its shape and its strength, allowing acid to flow upward, causing further damage to the LES.
2. Smoking
Smoking exposes the oesophagus to several toxins and chemicals that damage the membrane (lining) in the LES, causing it to weaken. Smoking also raises the acidity of stomach fluids which can impact the LES more strongly than regular stomach acid.
3. Alcohol
Alcohol is known to be a trigger for people with GERD. But, even for people who do not have GERD, regular consumption of alcohol can reduce the LES’ ability to close. Alcohol relaxes the LES muscle and allows stomach acid to flow upward which, over time, can cause structural damage to the LES.
4. Certain Medications
Several types of medications can damage your LES by causing it to relax excessively. If taken regularly, these drugs keep the LES in a relaxed state, allowing acid reflux that can damage the LES muscle and membrane (lining). Medications that pose this risk include blood pressure drugs, sleeping pills, sedatives, antibiotics, antidepressants, iron and potassium supplements, and proton pump inhibitors.
5. Certain Foods
People with GERD must always avoid trigger foods. If you feel that you are at risk for developing GERD, you may want to avoid or limit certain foods as well. For example, high-fat foods tend to cause the LES to relax. Reducing your daily intake of high-fat foods can therefore help protect the LES and prevent GERD.
If you suffer from heartburn and acid reflux, then you may want to protect your LES from these risks. While not all heartburn and reflux indicate GERD, if these symptoms are frequent due to your diet and lifestyle choices, then you may be damaging your LES and potentially GERD.
References and Further Reading
Cleveland Clinic (2021). Esophageal Disorders, https://my.clevelandclinic.org/health/diseases/16976-esophageal-disorders#prevention, last reviewed on 08/10/2021
MedicalNewsToday (2022). The esophageal sphincter: Upper, lower, and how it works, https://www.medicalnewstoday.com/articles/the-esophageal-sphincter, written by Zawn Villines on January 28, 2022
