What is GERD?

I. Etiology: Common—may affect up to 80% of the population to varying degrees. The normal barrier against reflux is provided by multiple actors. A. LES: normally provides a high-pressure zone B. Esophagogastric junction: normally rests within the abdominal cavity, and the positive intraabdominal pressure adds tone to the LES C. Angle of His (acute angle created between the junction of the lower esophagus and the cardia of the stomach): When the angle is disrupted, as with a hiatal hernia , gastric contents more easily traverse the LES. D. Esophageal motility: Some reflux is physiologic, but a normally functioning esophagus clears the refluxate. In cases of esophageal dysmotility, peristalsis is not adequate to clear the refluxed secretions.