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Because the acid backs up into the esophagus, the esophagus may be damaged. Hiatal hernias are not a pre-requisite for acid reflux, but a large amount of people with acid reflux DO have hiatal hernias. People with acid reflux have a problem with the contraction of the esophageal muscles when they swallow. . The location of the sac is near the esophagus. When we eat or drink the LES allows the food to pass into the stomach and then the muscle ring closes so the food does not reflux. It takes about six hours from the last cigarette you smoke for the effect on the esophagus to wear off. Or, the LES may be too relaxed. People with acid reflux (GERD) may have abnormalities with their LES. Acid reflux can also be caused by a hiatal hernia due to the hernial sac. Acid reflux (GERD) can have many causes. It is always better to be vertical so gravity can help the acid move down into the stomach. If there is not a good contraction then the acid does not get pushed back and remains in the esophagus. This is a problem because the diaphragm is a large part of helping the LES to prevent reflux. Some people with acid reflux have hiatal hernias and some do not. Acid reflux is most common after meals. Smoking disturbs the clearing of the esophagus too. The longer the LES is open (relaxed) reflux can easily occur. Large meals are not recommended for people with acid reflux.

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