Causes of Gastroesophageal Reflux Disease

In healthy individuals, lower esophageal sphincter is contracted tonically. It relaxes when the food is being swallowed.

  • Inappropriate relaxation of the lower esophageal sphincter
  • Reduced lower esophageal sphincter tone

When LES opens, stomach contents with acid regurgitate into esophagus.

Contributing Factors

  • Delayed esophageal clearance (Defective esophageal peristalsis)
  • Delayed gastric emptying
  • Diet: Heavy meals, Fat, chocolate, coffee and alcohol can relax the LES sphincter
  • Cigarette smoking
  • Drugs – antimuscarinic, calcium channel blockers, nitrates
  • Systemic sclerosis
  • Increased intra-abdominal pressure: Obesity, Pregnancy

Hiatus hernia can aggravate the disease.