Pathophysiology

  • Weakened esophageal cleansing
  1. Esophageal peristalsis
  2. salivation
  • Gastric emptying disorders
  1. delayed gastric emptying
  2. Intragastric pressure
  • Acid hypersecretion
  1. Prolonged acid exposure
  • Disorder in the antireflux mechanism
  1. Inferior esophageal sphincter
  2. Extrasphincteric components
  • Esophageal mucosal resistance
  1. mucus layer
  2. epithelial barrier

      Pump

      • Volume clearance is related to esophageal peristalsis and gravity.
      • Chemical cleansing is related to saliva secretion.

      Reasons

      • Decreased volume clearance (hiatal hernia)
      • Decreased chemical clearance (decreased salivation).

      Reservoir

      Gastric Function Abnormalities in Gerd

      • increased intragastric pressure
      • gastric dilatation
      • decreased ejaculation time
      • increased acid secretion