When the valve that separates the stomach from the esophagus—the lower esophageal sphincter, or LES—isn’t closed tightly, it can lead to heartburn.
Hiatal hernia
Normally, pressure from the diaphragm—the large muscle separating the stomach and the chest—helps hold the LES valve closed.
Pregnancy
The hormonal changes during the first trimester of pregnancy seem to weaken and relax the LES, says Dr. DeVault. But during the later stages of pregnancy, pressure is the big problem.
Weakened valve
About one in four people with gastroesophageal reflux disease (GERD), a condition characterized by two or more bouts of heartburn a week, have a weakened LES valve.
Slow digestion
A small group of people with chronic heartburn may have what is called delayed gastric emptying, where “the stomach simply doesn’t empty in the right direction," says Dr. DeVault. "Instead of going the appropriate forward way, it goes the wrong way and reflux occurs."
Obesity
"There’s been studies that show eating too much, eating too fast, and eating the wrong things—high-fat foods, carbonated beverages—are the things that tend to promote reflux," says Dr. DeVault.
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