What causes heartburn? - Rusha Modi

譯者: Lilian Chiu 審譯者: Helen Chang

Just between your chest and abdomen

在你的胸部和腹部之間，

is where you’ll find one of the most important muscles

有個非常重要的肌肉，

you probably didn't know you had:

你可能不知道它的存在：

the lower esophageal sphincter, or LES.

下食道括約肌，縮寫 LES。

When functioning properly,

當這一圈組織妥當運作的時候，

this ring of tissue plays a crucial role in helping us eat.

它是協助我們進食的關鍵角色。

But when the LES malfunctions,

但當 LES 機能失常時，

it becomes the main player in heartburn

它就成了胃灼熱的主要成因了。

--a searing, sometimes sour-tasting chest-spasm

胃灼熱是一種燒灼的胸痙攣， 有時還帶有酸味，

that many people will experience at some point in their lives.

許多人在一生中都會經歷到。

We know that humans have been battling heartburn

我們知道人類一直在對抗胃灼熱，

for hundreds, if not thousands of years.

若沒有數千年，也有數百年。

But recently the incidence has risen,

但近期，發生率開始提升，

making it a common stomach complaint worldwide.

讓它成為全球一種 常見的胃部不適。

When the symptoms of heartburn become more more regular and intense

當胃灼熱的症狀變得 越來越頻繁、越來越強烈，

—such as twice a week or more--

——比如一週兩次，或更頻繁——

it’s diagnosed as Gastroesophageal Reflux Disease, or GERD.

會被診斷為胃食道逆流，

縮寫為 GERD。

But what causes this problem,

但這個問題是怎麼造成的？ 要如何讓它停止？

and how can it be stopped?

Heartburn starts in an area called

胃灼熱是從「胃食道連接部」 這個區域開始發生的，

the gastroesophageal junction, where the LES resides.

也就是 LES 的所在。

This smooth, muscular ring of the LES

LES 這一圈平滑的肌肉

is moderated by an intricate tree of nerve roots

是由錯綜複雜的樹狀 神經根來管控的，

that connect to the brain, the heart, and the lungs.

這些神經根和大腦、 心臟，以及肺部相連。

After food enters the stomach from the esophagus,

在食物從食道進入胃部之後，

the muscle’s task is to stop it

這塊肌肉的任務就是阻止食物

from surging back up again.

再次向上回衝。

The LES contracts, squeezing the stomach entrance

LES 收縮，擠壓胃部的入口，

and creating a high pressure zone

創造出一個高壓區，

that prevents digestive acids from seeping out.

避免胃酸漏出。

But if the LES relaxes at the wrong moment or gradually weakens,

但如果 LES 在不對的時候放鬆，

或是漸漸弱化，

it becomes like a faulty, ill-fitting lid,

它會變成像是一個 不完善、不吻合的蓋子，

causing the area to depressurize.

造成該區域減壓。

That allows burning stomach acid--

那就會讓燒灼的胃酸， 甚至食物塊噴出來，

and even chunks of food--to spurt into the

然後進入食道，

esophagus, sometimes going as far up as the mouth.

有時還會衝到嘴巴這麼遠。

The cause of all this internal drama

這種在體內上演的情節

has long been put down to diet.

一直都被歸因為飲食。

Foods like caffeine and peppermint contain

像是咖啡因以及薄荷這些食物，

其成分可能會造成 LES 放鬆，

ingredients that may have a relaxing affect on the LES,

which makes it incapable of doing its job.

讓它無法好好地工作。

Other acidic foods, like citrus and tomatoes,

其他酸性食物，比如柑橘和蕃茄，

can worsen irritation of the esophagus

與胃酸一起釋放出來時，

when they leach out with stomach acid.

會讓食道的刺激更嚴重。

Carbonated beverages can similarly

汽水也很類似，會在胃部中冒泡，

bubble up in the stomach,

forcing open the valve.

迫使閥門打開。

But researchers have discovered that food isn’t the only trigger.

但研究者發現， 觸發因子不僅是食物。

Smoking poses a risk, because the nicotine in cigarettes relaxes the LES.

抽菸也會造成風險，

因為香菸中的尼古丁 會讓 LES 放鬆。

Consuming excessive amounts of alcohol

飲酒過量也會有類似的效應。

may have a similar effect.

Pregnant women often experience more heartburn

孕婦常發生胃灼熱，

due to the pressure of a growing baby on their stomachs.

是因為胎兒的成長 會對她們的胃部產生壓力，

and the levels of certain hormones in their bodies.

她們體內某種荷爾蒙的量 也是一個原因。

Obesity can cause hernias that disrupt

肥胖會造成疝氣，

破壞胃食道連接部本來是用來保護

the anti-reflux barrier of the gastroesophageal junction

that normally protects against heartburn.

避免胃灼熱的抗逆流阻障。

Numerous medications, including those for asthma,

數種藥物，包括氣喘、

high blood pressure, birth control, and depression

高血壓、避孕，和憂鬱用的藥物，

can also have unintended effects on the LES.

也可能無意間對 LES 產生影響。

An occasional bout of heartburn isn't

若只是偶發的胃灼熱就不需擔心。

necessarily something to worry about.

But, if heartburn starts happening regularly,

但如果胃灼熱開始頻繁發生，

it can weaken the LES muscle over time,

LES 可能會隨時間變弱，

letting more and more acid escape.

讓更多的酸流出來。

And if it goes untreated,

如果沒有治療， 可能會造成更大的問題。

this can cause bigger problems.

Over time, constant acid leakage from heartburn

胃灼熱的胃酸外漏 持續一段時間之後，

may form scar tissue which narrows the

可能會形成疤組織，讓食道變窄，

esophageal tube, making it harder to swallow food.

讓吞嚥食物變得更困難。

Ongoing reflux can also damage the cells

不斷逆流也可能會傷害食道細胞，

lining the esophagus--a rare condition called

這是一種罕見疾病， 叫做巴雷斯特食道症，

Barrett’s esophagus, which can elevate

它會增加食道癌的風險。

the risk of esophageal cancer.

Luckily, heartburn is often treatable with

幸運的是胃灼熱通常 可以用一些藥物治療，

a range of medicines that can help

neutralize or reduce stomach acid.

有助於中和或減少胃酸。

In extreme cases, some people have surgery

有些很極端的個案是透過手術

to tighten the LES to minimize their distress.

讓 LES 變緊，減少其痛苦。

But we can often stop heartburn

但我們通常都可以在演變到 這種地步之前就阻止胃灼熱。

before it reaches that point.

Reducing the consumption of certain foods,

減少食用某些食物，

not smoking, and maintaining a healthy weight

不要抽菸，保持健康的體重，

can all dramatically reduce reflux.

都能顯著減少逆流。

With proper care we can help our LES’s keep

有妥善的照顧， 我們就能幫助我們的 LES

the chemical fountain of our stomachs in proper order

把我們胃部的化學噴泉給管控好，

and avoid having to feel the burn.

進而避免必須經歷這種灼熱感。