A burning pain in the chest every night, reflux esophagitis is no longer an unfamiliar condition. Modern medicine diagnoses this as gastroesophageal reflux disease, referring to a state where gastric acid or stomach contents reflux into the esophagus, irritating the esophageal mucosa and causing inflammation.
One of the core causes is dysfunction of the lower esophageal sphincter located between the stomach and esophagus. This sphincter should normally remain tightly closed and open only when swallowing food. When it loosens due to various factors, gastric acid easily refluxes into the esophagus.
Why does this sphincter loosen? First, certain foods are the main culprits. High-fat foods delay digestion and increase pressure within the stomach, relaxing the sphincter. Caffeine, chocolate, mint, and alcohol directly relax the sphincter itself. We also cannot overlook wheat, or flour-based foods, mentioned in Donguibogam. Flour loses dietary fiber during refining, and because of gluten, it lengthens the digestive process and places a burden on the stomach. This can stimulate gastric acid secretion and keep stomach contents lingering longer, raising the likelihood of reflux. In addition, certain vegetables like onions, garlic, and tomatoes can cause excessive gastric acid secretion or induce gas during digestion, thereby increasing pressure within the stomach.
Second, while gastric hyperacidity is important in stomach contents refluxing into the esophagus, delayed gastric emptying also plays a major role. When the stomach fails to empty food in a timely manner and retains it for long periods, pressure inside the stomach rises, making reflux easy. This is closely related to poor eating habits such as irregular meals, overeating, and late-night snacking.
Third, stress and autonomic nervous system imbalance are key factors. Stress lowers the activity of the parasympathetic nervous system, weakening digestive function and making gastric acid secretion irregular. It also sensitizes esophageal and gastric sensation, making one feel greater pain even from minor reflux. In other words, while stress does not directly cause sphincter relaxation, it acts as an important factor that worsens symptoms of reflux esophagitis and amplifies discomfort.
Finally, increased intra-abdominal pressure is also significant. Tight clothing, obesity, and pregnancy raise abdominal pressure and can trigger acid reflux. The damp-heat and hindrance of the unimpeded flow of qi discussed in Donguibogam can be understood through the combined mechanisms described in modern medicine, such as delayed gastric emptying, increased pressure within the stomach, and gastric mucosa damage from irritating foods. Ultimately, a state where the body's balance is broken and becomes vulnerable to external stimuli manifests as reflux esophagitis.
