Just between your chest and abdomen is where you’ll find one of the most important muscles you probably didn't know you had: the lower esophageal sphincter, or LES. When functioning properly, this ring of tissue plays a crucial role in helping us eat. But when the LES malfunctions, it becomes the main player in heartburn --a searing, sometimes sour-tasting chest-spasm that many people will experience at some point in their lives.
就在你的胸部和腹部之间, 有一个你所不知的 非常重要的肌肉组织: 那就是食管下括约肌,简称 LES。 当 LES 正常运作时, 这个组织环对我们的进食功能 有很重要的促进作用。 而当 LES 不能正常运作时, 它就成了导致胃灼热的罪魁祸首—— 这是一种灼热的, 有时带有酸味的胃部痉挛, 许多人在一生中或多或少 都会有这样的经历。
We know that humans have been battling heartburn for hundreds, if not thousands of years. But recently the incidence has risen, making it a common stomach complaint worldwide. When the symptoms of heartburn become more more regular and intense —such as twice a week or more-- it’s diagnosed as Gastroesophageal Reflux Disease, or GERD. But what causes this problem, and how can it be stopped?
我们知道人们千百年来 都在试图战胜胃灼热。 但近年来,胃灼热 的发病率反而不断增高, 成为了令人困扰的世界性胃病问题。 当胃灼热的症状的发作变得 更加频繁和剧烈时, 比如说一个星期两次或者更多, 就会被诊断为胃食管反流, 又称 GERD。 那么,是什么造成了胃灼热? 用什么办法才可以消除这些症状呢?
Heartburn starts in an area called the gastroesophageal junction, where the LES resides. This smooth, muscular ring of the LES is moderated by an intricate tree of nerve roots that connect to the brain, the heart, and the lungs. After food enters the stomach from the esophagus, the muscle’s task is to stop it from surging back up again. The LES contracts, squeezing the stomach entrance and creating a high pressure zone that prevents digestive acids from seeping out.
胃灼热由 LES 所在 的胃食管交界处产生, LES 这一圈平滑肌 是由错综复杂的神经根调节, 这些神经与大脑, 心脏和肺部相连。 当食物从食管中进入胃部, 这一圈肌肉的功能就是阻止 食物返流。 LES 收缩,挤压胃上口 产生一个高压力区, 防止胃酸流入食道。
But if the LES relaxes at the wrong moment or gradually weakens, it becomes like a faulty, ill-fitting lid, causing the area to depressurize. That allows burning stomach acid-- and even chunks of food--to spurt into the esophagus, sometimes going as far up as the mouth.
但如果 LES 没有及时收紧, 或者功能逐渐失调时, 密封性就会变差, 这个部位的压力就会减弱, 导致灼烧的胃酸 甚至食物返流, 进入食管,甚至口中。
The cause of all this internal drama has long been put down to diet. Foods like caffeine and peppermint contain ingredients that may have a relaxing affect on the LES, which makes it incapable of doing its job. Other acidic foods, like citrus and tomatoes, can worsen irritation of the esophagus when they leach out with stomach acid. Carbonated beverages can similarly bubble up in the stomach, forcing open the valve.
长久以来,人们认为日常饮食习惯 是造成这一内部闹剧的罪魁祸首。 比如说,咖啡因和薄荷中的成分 可能有松弛 LES 的作用, 让它无法正常运作。 其他的酸性食物, 比如柑橘和西红柿 和胃酸一起滤出时, 会刺激食管。 而碳酸饮料 在胃里产生气泡时, 也会使 LES 强制打开。
But researchers have discovered that food isn’t the only trigger. Smoking poses a risk, because the nicotine in cigarettes relaxes the LES. Consuming excessive amounts of alcohol may have a similar effect. Pregnant women often experience more heartburn due to the pressure of a growing baby on their stomachs. and the levels of certain hormones in their bodies. Obesity can cause hernias that disrupt the anti-reflux barrier of the gastroesophageal junction that normally protects against heartburn. Numerous medications, including those for asthma, high blood pressure, birth control, and depression can also have unintended effects on the LES.
但研究者们发现, 食物并不是导致发病的唯一因素。 吸烟也构成了威胁, 因为香烟中的尼古丁会使 LES 松弛。 饮酒过量 也会产生这种效果。 孕妇常常经历胃灼热, 不仅因为她们肚中成长的胎儿 对其胃部施加压力, 还与她们孕时 的荷尔蒙水平变化有关。 肥胖症所造成的疝气会损坏 胃食道交界处的抗逆流屏障, 使其失去对抗胃灼热的功能。 很多针对哮喘, 高血压,避孕和抑郁症的药物 也会对 LES 产生副作用。
An occasional bout of heartburn isn't necessarily something to worry about. But, if heartburn starts happening regularly, it can weaken the LES muscle over time, letting more and more acid escape. And if it goes untreated, this can cause bigger problems.
偶尔的胃灼烧 无须担心, 但如果胃灼热发生频繁, 则会使 LES 的功能衰退, 导致更多的胃酸返流入食道。 如果不及时治疗的话, 会引发更大的问题。
Over time, constant acid leakage from heartburn may form scar tissue which narrows the esophageal tube, making it harder to swallow food. Ongoing reflux can also damage the cells lining the esophagus--a rare condition called Barrett’s esophagus, which can elevate the risk of esophageal cancer.
久而久之,因胃灼热 而不断渗出的胃酸 可能会灼伤食道, 从而产生瘢痕组织, 使得食道变窄,吞咽食物困难。 持续的胃酸逆流也会损伤 食道粘膜的细胞, 导致一种罕见的疾病, 叫做巴洛氏食道症, 从而提高患食道癌的风险。
Luckily, heartburn is often treatable with a range of medicines that can help neutralize or reduce stomach acid. In extreme cases, some people have surgery to tighten the LES to minimize their distress.
幸运的是,当前有很多的药物 都能通过中和或者减少胃酸的方式 来治疗胃灼热。 在极少数的情况下, 患者需要通过手术治疗 来缩紧 LES,从而缓解他们的病症。
But we can often stop heartburn before it reaches that point. Reducing the consumption of certain foods, not smoking, and maintaining a healthy weight can all dramatically reduce reflux. With proper care we can help our LES’s keep the chemical fountain of our stomachs in proper order and avoid having to feel the burn.
其实,我们能在胃灼热 变得严重前预防它。 比如说,改善我们的饮食习惯, 不抽烟,保持健康的体重, 这些都能大大地减少胃食管返流。 只要我们采取对的措施, 维护好我们胃部的“化学喷泉” LES, 就能避免体验胃灼热感。