What Causes The Lower Esophageal Sphincter To Fail?


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Why is the LES so important?  The lower esophageal sphincter is a tight muscle located at the end of the esophagus. The function of the LES is to relax only when food passes into the stomach from the esophagus.  Any other time, this muscle should be tight and closed to ensure that food contents and digestive acids remain within the stomach.

However, this isn’t always the case.  Reflux can and does occur when the pressure or tightness of the LES decreases.  This causes the muscle to weaken and malfunction, allowing acid from the stomach to backup into the esophagus.  There are many factors that can cause the LES to relax and result in acid reflux.

Some factors are related to lifestyle choices, while some are hereditary, these factors include:

Lifestyle choices:

Beverages and foods that relax the LES – For many acid reflux sufferers, their condition is triggered by certain foods and beverages they consume such as:
- Fatty and fried foods (I.E. processed and deep fried foods)
- Hot spicy food (I.E. hot pepper and sauces)
- Citrus fruit (I.E. orange, grapefruit, lemon)
- Tomato and tomato based products
- Onions
- Chocolate
- Mint candy
- Citrus juice
- Caffeinated beverages ( I.E. coffee (including decaffeinated coffee), tea, soda, energy drinks)
- Alcohol

The above listed foods and beverages are known to weaken the LES, which can cause it to relax, allowing acid to seep through the muscle and be refluxed into the esophagus.

Overeating – Many of us have grown up with the bad habit of overeating.  Ingesting three large meals a day is difficult on the digestive system, and so are the other poor eating habits that are often followed while eating large meals including, eating too quickly and eating while lying down or on the move.  If your stomach has puffed up and you feel “stuffed” or “bloated” after consuming your meal, you’ve eaten too much.  Overeating causes the digestive process to slow down and places pressure on the stomach, which causes the stomach to press harder against the lower esophageal sphincter, which in turn can lead to acid reflux.

Excessive weight and Obesity – When you are overweight the additional body weight places extra pressure on the stomach.  This decreases the volume of the stomach which places pressure on the LES and can force food up into the esophagus.  How can you tell if you need to lose weight? You can determine if you are a healthy weight by calculating your Body Mass Index (BMI).  BMI is a measure of body fat that is based on a person’s height and weight.  When calculated, if BMI is 25 – 25.9, a person is considered overweight, and if it is 30 or over, a person is considered obese.  You can calculate your BMI online.

Smoking – Smoking can trigger acid reflux as the chemicals in cigarette smoke reduce the function of the LES, weakening the muscle and thereby allowing acid reflux to seep up into the esophagus.

Sleeping – When we sleep, our body relaxes, including the organs and muscles in our body.  Therefore, many systems slow down and do not function in the way they would when we are awake.  This includes the digestive system.  That is why acid reflux and heartburn tend to occur most frequently at night.  The LES does not function with the same capacity during sleep.  Hence, for those who eat or drink anything but water a few hours before bed or lying down; the LES will not be able to work at its best, increasing the risk of acid reflux.

Intense Exercises – High impact exercises such as jogging, jumping jacks, intense aerobics, sit-ups, stomach crunches, etc., cause the stomach muscles to contract excessively.  This places both the stomach and LES under extreme pressure, resulting in a weakened LES and potentially acid reflux.

Tight clothing – clothing that wraps tightly around the abdomen such as belts, corsets, girdles, taut pants, tights, and pantyhose, can squeeze the stomach, forcing food up against the LES leading to a reflux of acid into the esophagus.

Pregnancy – Many expectant mothers who are in the third trimester of their pregnancy are prone to heartburn because as their uterus increases in size, it increases pressure on the stomach, which, in turn, increase pressure on the LES causing it to weaken and malfunction.

Hereditary factors:

Hiatal Hernia  – This is a condition that is believed to impair the LES function and worsen gastroesophageal reflux disease (GERD) symptoms.  It occurs in the small hole within the diaphragm known as the hiatus.  The purpose of the hiatus is to secure the passageway between the stomach and the esophagus.  The esophagus goes through the hiatus in order to connect to the stomach so that the organs can remain separate.  A properly functioning hiatus is tight, but in some people it can become weak and enlarge.  The stomach can protrude into the larger opening through the diaphragm and into the chest.  When this occurs, the condition is known as a hiatal hernia.  Studies have suggested that those with relatives who have hiatal hernias are at a higher risk of developing it.

Other hereditary factors linked to a weakened LES include factors that have already been discussed – obesity and overeating.

Remember, understanding how acid reflux occurs, and why the LES fails is crucial if you want to know how to avoid it.  After all, the weaker your LES becomes the more chance there is that it will malfunction and there is the risk that it may become permanently damaged, making acid reflux experiences more frequent.


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7 Responses

  1. gil passarella
    April 2nd, 2009 | 12:18 pm

    thanks for your info. it has helped me a great deal. passarella

  2. Diane Schumacher
    April 2nd, 2009 | 7:34 pm

    You informed us of a weak Hiatus and what it does, but not what to do if you have one. After tests my doctor informed me I have a small hiatal hernia.
    I’ve tried ever so many things you suggested and they all help some, but the least stress or problems with medication and off the acid reflex goes!

  3. Lorraine Travers
    April 2nd, 2009 | 9:18 pm

    I have Barretts Disease - is there away that it can be
    reveresed or can something else be done. I am getting pains just about each day - already had a GI done last May
    probably going again for another GI soon
    All the information you could supply to me would be apreciated.

    Many thanks Lorraine

  4. daniel botelho
    April 4th, 2009 | 5:17 pm

    I would like to know things that can be done to make the LES stronger once it has been weakened?

  5. Cynthia Shillingford
    September 7th, 2009 | 11:36 pm

    I have been experiencing acid reflux for sometime now ane would really like to get rid of it naturally

  6. ali ash
    May 8th, 2010 | 5:45 am

    hey , gr8 article :) … but i wanted to ask , does the age affect LES ?? ….

  7. nancy paparo
    April 19th, 2012 | 1:55 pm

    Thank you for the info. Very helpful

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