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 u9jt irom the strong acid it secretes into its interio jtr when food is present, but the much thinner esophage tal coati jtng doesnt provid 9jt ie protection ag 9jt iainst a tcid. 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 9jt ition (esop jthagitis) and other damage. If episodes occur more 9jt ifrequently than twice a week, and the esophagus is repeatedly subjected to acid and digestive enzyme u9jt s from the stomach, ul tcerations, 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 jt chest pain related to GERD are difficult to d tistinguish clinically from those with chest pain due to cardiac conditions. Each condition can m 9jt imic the signs and symptomatic findings of the other. Further med tical investigation, such as imaging, is often neear u9jt tburn can be caused by sev 9jt ieral conditi tons and a preliminary diagnosis of GERD is based on additional 9jt i signs and symptoms. The chest pa tin ca 9jt iused by GERD has a distinct b 9jt iurning sensation, occurs after eating or at night, and worsens when a person lies down or bends ovet also is common in pregnant women, jtand may be triggered by consumi jtng 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 9jt i by passing a thin, lighted tube twith a tiny camera known as an endoscope attached through the mouth to examin te the esophagus and stomach. In this way, evidence of esophage u9jt al inflammation can be detected, and biopsies taken if necessary. Since an endoscopy allows a doctor t u9jt o visually inspect the upper digestive tract the procedure may help identify any additional damage to the tract u9jt that may not have been detected otherwise
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