Although GERD has a variety of causes, the common denominator is that some function of the upper digestive system has a problem. The heartburn might stem from overall poor digestive muscle tone, or sluggish muscles of the esophagus that are too weak to quickly clear away food or acid. Sometimes the stomach muscles aren't working at their peak. In the case of acid reflux, often a combination of several factors is at work.
If the esophagus becomes damaged from the acid reflux, this condition is called esophagitis. The damaged esophagus can contribute to the continuation or worsening of the GERD problem. Because treatment will improve this condition, taking action by following your physician's advice is very important and should be done at once. Read about diagnoses and treatment in the chapters that follows.
Not all people who suffer from GERD experience esophagitis. Approximately half the people diagnosed with GERD do not have esophagitis; some doctors call this condition noneroive reflux disease, or NERD. The patients have symptoms of GERD, but on endoscopy, the esophagus is normal.
When the food reaches the stomach entry point, the lower esophageal sphincter opens. The LES is a sort of one-way valve that functions as a door into the stomach. The pulsation pushes food through that door, and the door closes - until it's time to move more food into the stomach all over again