Gastro Esophageal Reflux Disease & Acidity.
A word of caution
There are a number of extremely educative web-sites listed at the end of this page, they will be helpful to you to make
educated decisions. The providing of links no way implies that these institutions recommend or endorse our
products. All the materials on this site are for your reference only. You will find detailed images for various GERD
conditions at image galary of Gastrolab.net .
Acidity / GERD.
Though Acidity & GERD(Gastro Esophageal Reflux Disease) are not the same, they are usually closely related. In our
discussion “How stomach works” we have seen the food ingested passes through the Esophagus before entering
the Stomach. There is a valve called LES(Lower Esophageal Sphincter) to ensure that it is a one-way transit and the
food is prevented from backwashing in to Esophagus by closing of this valve. Nature has done so to make sure that
the strong acids and Pepsin inside the stomach (required to dissolve and breakdown the food inside the stomach
cavity and to kill off most of the bacterium that comes along the food in to the stomach) does not backwash in to
Esophagus. Unlike stomach, Esophagus does not have cellular protection against these acids. But nature has
provided additional protection to Esophagus by providing human beings with an Alkaline (Opposite of acid) saliva and
a acid neutralizing bi-carbonate secretion flowing in to Esophagus. These neutralizers make any spill over of acid
from stomach to Esophagus harmless.
Stomach is situated just below the diaphragm with distal neck of the Esophagus passing through a narrow opening in
the diaphragm. This ensures that the high pressure felt by contents of the stomach during Peristalsis (crunching
down of the food by stomach) does not force it in to Esophagus. In some people however this diaphragm opening is
larger thus a portion of the stomach is forced in to chest cavity (Hiatal Hernia) during Peristalsis. Thus in such cases
there is a greater chance of acidic stomach contents spilling over to Esophagus.
In some other cases the LES valve is less than perfect and does not fully close with required strength or opens at
wrong times or remains open for too long, thus providing opportunity for wash back of acidic stomach contents in to
the Esophagus. In such cases the acid basically burns the Esophagus tube as shown on the left top corner of the
picture below. This condition of acid wash back is called GERD. .
Sach Health Supplies LLC.
People with GERD have an Esophgeal pH of 4 or less. One way to determine GERD has been to monitor ( for a 24 hrs
period) the pH of Esophagus.
{Now for those of you who slept off the chemistry class. Pure water is considered neutral and has the exact middle pH
value of 7.0, on the pH scale varying from 0 to 14. On this scale pH value of 6 means a little acidic and a pH value of 8
means a little Alkaline/Basic. It should be noted that a pH value of 5 means ten times more acidic than pH value of 6.
Similarly a pH value of 4 means 10 times more acidic than pH of 5 and 100 times more acidic than a pH of 6. Such a
scale is called log scale in Maths}
Most GERD conditions are visible using an endoscope (Tiny camera probing the esophagus).
Unlike the popular belief of LES lack of pressure being the cause of GERD, only about 25% of GERD patients show a
lack of LES pressure (<10 mm Hg) in Manometric measurements. Or in other words 75% of the GERD patients are due
to factors other than LES pressure deficiency.
A clear acid burn mark is visible in otherwise clean Esophagus. The opening to the stomach is visible deep below as
a small slit. . Photo images are Courtesy of Gastrolab.net.
This condition is called as heart burn – It is a misnomer since it is not your heart that burns but it is the Esophagus
tube passing by the side of your heart.
The problem of having such a spill over is that over time the acid can cause serious erosion (reflux esophagitis) of
the Esophagus(see picture below) or cause growth of strictures or blockages with in Esophagus ( this is result of
Esophagus trying to repair itself.).
A cumulative erosion of Esophagus due to GERD.
Photo images are Courtesy of Gastrolab.net.
Stricture formed in Esophagus due to GERD.
Photo images are Courtesy of Gastrolab.net.
In some cases when the Esophagus try to repair itself, the type of tissue grown results in replacement of native
Esophagus tissue(Squamous epithelium) by tissues (metaplastic columnar epithelium) which are similar to stomach
tissues. This condition is called Barrett’s Esophagus (BE). This may over time progress to tumorous condition called
Esophageal adenocarcinoma. In some cases it may further worsen to Esophageal cancer, which is a very serious
condition..
