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.