Modern medicine views symptoms such as a burning pain from the epigastrium to the throat, acid regurgitation, and a foreign body sensation in the throat as major signals of gastroesophageal reflux disease. Beyond simple heartburn, this refers to a condition where gastric acid or stomach contents chronically reflux into the esophagus, causing damage to the esophageal mucosa. It is also very important to recognize that a significant portion of chest pain suspected to be cardiac in origin is actually non-cardiac chest pain arising from gastroesophageal reflux.
Why does this reflux occur? One of the greatest causes is dysfunction of the lower esophageal sphincter. Located between the stomach and esophagus, the lower esophageal sphincter acts as a valve that remains closed normally and opens only when swallowing food to prevent stomach contents from refluxing into the esophagus. However, when this sphincter weakens or relaxes abnormally often, gastric acid easily enters the esophagus. High-fat foods, caffeine, alcohol, chocolate, and mint can induce sphincter relaxation, and smoking is also a major culprit impairing lower esophageal sphincter function.
In addition, reflux can worsen when intra-abdominal pressure increases due to obesity or pregnancy, or in conditions favoring reflux, such as the habit of lying down immediately after eating late at night. Stress and gastroesophageal reflux disease are especially inseparable. Excessive stress affects the autonomic nervous system, stimulating gastric acid secretion, decreasing esophageal motility, and raising esophageal pain sensitivity, which can make one feel greater discomfort even from minor irritation. Just as Donguibogam viewed liver fire attacking the stomach, stress is a core factor creating imbalance in the stomach.
Refluxed gastric acid induces inflammation and damage in the esophageal mucosa, causing heartburn; chronic injury can progress past esophagitis and esophageal ulcer, and rarely poses a risk of advancing to a precancerous lesion called Barrett esophagus. A foreign body sensation in the throat, chronic cough, and hoarseness are atypical symptoms resulting from gastric acid refluxing beyond the esophagus into the larynx or bronchus, often mistaken for a throat cold or another respiratory system disorder. Understanding these complex mechanisms is the first step toward effectively managing gastroesophageal reflux disease.
