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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.