Gastroesophageal reflux disease pathophysiology.

Gastroesophageal reflux disease is common in the Western world and affects a heterogeneous population. Structural and physiologic factors contribute to its pathophysiology, but the relative contribution of these individual factors varies between patients. Three main factors are generally central to the condition: TLESR, hypotensive LES tone, and hiatal hernia. In addition, several other factors (e.g., esophageal and gastric motility, salivary secretion, and mucosal defense mechanisms) modulate the extent of the injury produced by acid reflux.