Gastro esophageal reflux is throwing the contents of the stomach back up into the esophagus. The term reflux refers to movement in the opposite direction that is not physiological. That is, at reflux, the bolus is moving in the opposite direction – from the stomach into the esophagus.
Gastro esophageal reflux is a physiological phenomenon, if observed after a meal, not accompanied by any unpleasant symptoms or discomfort and if the number of reflux during the day is not large. Under normal gastro esophageal reflux esophageal mucosa has a number of mechanisms that protect it from damage with acidic stomach contents. These protective mechanisms of the esophagus include the following:
In case of violation of any particular mechanism or their co-ordination, there is an increase in the frequency and duration of reflux, especially at night, that provokes damage to the esophageal mucosa with the development of the inflammatory process. In this case we are talking about pathological gastro esophageal reflux. To distinguish these states from others there are used 2 definitions: gastro-esophageal reflux (for the physiological process) and gastro esophageal reflux disease or GERD (for the pathological process).
Inflammatory changes in the mucosa of the esophagus when reflux is due to the fact that the acidic contents of the stomach and digestive enzymes have a devastating effect on it. The mucosa of the esophagus is damaged because it is adapted to pass through it bolus with an alkaline reaction, and is thrown out of the stomach acidic contents.
Gastro esophageal reflux as a pathological and physiological, is characterized by the appearance of the following most common symptoms:
It is not always accompanied by the appearance of clinical reflux symptoms. The most common cause of GERD is the failure of the lower esophageal sphincter, which transmits the contents of the stomach back up into the esophagus, without creating obstacles in his path.