When Does Reflux Begin
In normal physiology when we think about the body, the stomach and the esophagus are connected together. The stomach contracts at a certain rate throughout the day. It creates what we’ll call the gastric yield pressure. The job of the lower esophageal sphincter is to hold that pressure back. So, as long as the sphincter is strong enough and has a basis of a minimum of 4 millimeters of mercury pressure greater than what the stomach can generate, then reflux does not occur.
But, as the sphincter weakens over time and the amount of pressure that the sphincter can generate goes down, that allows the stomach pressure to exceed the sphincter strength. That’s when you have unchallenged reflux and that’s when the disease begins.