Just between your chest and abdomen lies a crucial muscle you might not be aware of: the lower esophageal sphincter (LES). This ring of tissue plays a vital role in our digestive process. However, when it malfunctions, it becomes the main culprit behind heartburn—a burning, sometimes sour-tasting sensation in the chest that many people experience at some point in their lives.
Heartburn has been a human ailment for hundreds, if not thousands, of years. Recently, its incidence has increased, making it a common stomach complaint worldwide. When heartburn symptoms become more frequent and intense—occurring twice a week or more—it is diagnosed as Gastroesophageal Reflux Disease (GERD). But what causes this issue, and how can it be mitigated?
Heartburn originates at the gastroesophageal junction, where the LES is located. This smooth, muscular ring is controlled by a complex network of nerve roots connecting to the brain, heart, and lungs. After food passes from the esophagus into the stomach, the LES’s job is to prevent it from flowing back up. It contracts, creating a high-pressure zone that stops digestive acids from escaping. However, if the LES relaxes at the wrong time or weakens, it acts like a faulty lid, allowing stomach acid—and sometimes food—to surge into the esophagus, occasionally reaching the mouth.
Diet has long been blamed for heartburn. Foods such as caffeine and peppermint contain ingredients that relax the LES, impairing its function. Acidic foods like citrus and tomatoes can exacerbate esophageal irritation when mixed with stomach acid. Carbonated drinks can also cause pressure in the stomach, forcing the valve open. However, research shows that food isn’t the only trigger. Smoking, due to nicotine’s relaxing effect on the LES, and excessive alcohol consumption can also contribute. Pregnant women often experience more heartburn due to the pressure of a growing baby and hormonal changes. Obesity can lead to hernias that disrupt the gastroesophageal junction’s anti-reflux barrier. Additionally, various medications, including those for asthma, high blood pressure, birth control, and depression, can have unintended effects on the LES.
An occasional bout of heartburn isn’t necessarily a cause for concern. However, frequent heartburn can weaken the LES over time, allowing more acid to escape. If untreated, this can lead to more severe issues. Chronic acid leakage may form scar tissue, narrowing the esophagus and making swallowing difficult. Ongoing reflux can also damage the esophageal lining, leading to Barrett’s esophagus, a rare condition that increases the risk of esophageal cancer.
Fortunately, heartburn is often treatable with medications that neutralize or reduce stomach acid. In extreme cases, surgery may be performed to tighten the LES and alleviate symptoms. However, heartburn can often be prevented before reaching such measures. Reducing the intake of certain foods, avoiding smoking, and maintaining a healthy weight can significantly decrease reflux. With proper care, we can help our LES maintain the stomach’s chemical balance and avoid the discomfort of heartburn.
Use an online tool to create an interactive diagram of the digestive system. Highlight the lower esophageal sphincter (LES) and its role in preventing acid reflux. Label other key parts of the digestive system and explain their functions. This will help you visualize where the LES is located and understand its importance in the digestive process.
Read a case study about a patient with GERD. Identify the symptoms, triggers, and treatments mentioned in the case study. Discuss in groups how the LES’s malfunction contributed to the patient’s condition and propose lifestyle changes that could help manage their symptoms.
Conduct an experiment to observe the effects of different foods on heartburn. Over a week, keep a food diary and note any instances of heartburn. Identify which foods seem to trigger symptoms and discuss why these foods might affect the LES. Share your findings with the class and suggest dietary adjustments to reduce heartburn.
In pairs, role-play a doctor-patient scenario where one of you is experiencing frequent heartburn. The “doctor” should ask questions to identify potential triggers and suggest lifestyle changes or treatments. This activity will help you practice communication skills and deepen your understanding of heartburn management.
Choose a treatment for GERD, such as medications, lifestyle changes, or surgical options. Research how this treatment works, its effectiveness, and any potential side effects. Create a presentation to share your findings with the class, explaining how the treatment helps manage GERD by addressing issues with the LES.
Muscle – A type of tissue in the body that has the ability to contract and produce movement. – Regular exercise helps to strengthen muscle tissue and improve overall fitness.
Heartburn – A burning sensation in the chest caused by acid reflux, where stomach acid flows back into the esophagus. – After eating spicy food, she often experiences heartburn that makes it uncomfortable to lie down.
Esophagus – The tube that connects the throat to the stomach, allowing food to pass through. – When swallowing, food travels down the esophagus before reaching the stomach.
Acid – A substance that can donate a proton or accept an electron pair in reactions, often found in the stomach to aid digestion. – Stomach acid is essential for breaking down food and killing harmful bacteria.
Reflux – The backward flow of stomach contents into the esophagus, often causing discomfort and heartburn. – Many people experience reflux after eating large meals or lying down too soon.
Diet – The kinds of food that a person habitually eats, which can impact health and well-being. – A balanced diet rich in fruits and vegetables is important for maintaining good health.
Obesity – A medical condition characterized by excessive body fat that increases the risk of health problems. – Obesity can lead to serious health issues such as diabetes and heart disease.
Symptoms – Physical or mental features that indicate a condition or disease. – Common symptoms of the flu include fever, cough, and body aches.
Treatment – The management and care of a patient for the purpose of combating a disease or condition. – Effective treatment for allergies may include medication and lifestyle changes.
Cancer – A disease caused by the uncontrolled division of abnormal cells in the body. – Early detection of cancer through regular screenings can significantly improve treatment outcomes.
