Disorders of the Gastrointestinal System, 2nd Edition
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Under normal conditions, the LES sus- tains enough pressure around the lower end of the esophagus to close it, thus preventing reflux of gastric or duodenal contents. The sphincter relaxes after ev- ery swallow, allowing food to pass into the stomach. In GERD, the sphincter does not remain closed because inadequate LES pressure or the pressure in the stomach
propels gastric contents into the esoph- agus from hiatal hernia or obesity. Stom- ach contents are very acidic and cause pain and irritation when they move into the esophagus. The esophageal mucosa becomes inflamed, which can decrease LES pressure more and more until there is a recurrent cycle of reflux and heartburn (Patti, 2021).
Figure 4. GERD
Note . BruceBlaus. (2015). GERD. https://commons.wikimedia.org/w/index.php?curid=44923646. CC BY-SA 4.0.
● Conditions that increase abdominal pressure (pregnancy, obesity, and persistent vomiting or coughing). ● Medications, including anticholinergics, benzodiazepines, NSAIDs, aspirin, nitroglycerin, albuterol, calcium channel blockers, antidepressants, and glucagon. ● Acidic foods and drinks (coffee, soda, alcohol, tomatoes).
Risk factors associated with the devel- opment of GERD (International Founda- tion for Gastrointestinal Disorders [IFF- GD], 2022): ● Hiatal hernia. ● Conditions that cause delayed gastric emptying (inflammation, obstruction, vagal nerve injuries, neuropathy. ● Conditions that cause LES dysfunction (obesity, smoking, alcohol use, certain medications, and high-fat foods).
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