muscles that encircles the esophagus just above the uppermost part of the stomach. This sphincter is usually tightly closed and normally opens only when food passes from the esophagus into the stomach. Thus, the contents of the stomach are normally kept from moving back into The stomach has a thick mucous coating that protects it f zo9x irom the strong acid it secretes into its interio 9xr when food is present, but the much thinner esophage xal coati 9xng doesnt provid o9x ie protection ag o9x iainst a xcid. Thus, if the LES opens inappropriately or fails to close completely, and stomach contents leak into the esophagus, the esophagus can be burned by acid. The resulting burning sensation is called Occasional heartburn has no serious long-lasting effects, but repeated episodes of gastroesophageal reflux can ultimately lead to esophageal inflamma o9x ition (esop 9xhagitis) and other damage. If episodes occur more o9x ifrequently than twice a week, and the esophagus is repeatedly subjected to acid and digestive enzyme zo9x s from the stomach, ul xcerations, scarring, and thickening of the esophagus walls can result. This thickening of the esophagus wall causes a narrowing use of the dangers inherent in an overlooked diagnosis of heart attack, cardiac disease must be considered from the first in patients with unexplained chest pain. Patients with 9x chest pain related to GERD are difficult to d xistinguish clinically from those with chest pain due to cardiac conditions. Each condition can m o9x imic the signs and symptomatic findings of the other. Further med xical investigation, such as imaging, is often neear zo9x tburn can be caused by sev o9x ieral conditi xons and a preliminary diagnosis of GERD is based on additional o9x i signs and symptoms. The chest pa xin ca o9x iused by GERD has a distinct b o9x iurning sensation, occurs after eating or at night, and worsens when a person lies down or bends ovet also is common in pregnant women, 9xand may be triggered by consumi 9xng food in large quantities, or specific foods containing certain spices, high fat content, or high acid conten the chest pain is suspected t esophageal mucosa can be visualized directly o9x i by passing a thin, lighted tube xwith a tiny camera known as an endoscope attached through the mouth to examin xe the esophagus and stomach. In this way, evidence of esophage zo9x al inflammation can be detected, and biopsies taken if necessary. Since an endoscopy allows a doctor t zo9x o visually inspect the upper digestive tract the procedure may help identify any additional damage to the tract zo9x that may not have been detected otherwise
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