Abnormality |
Contribution to GERD |
Gastric acid hypersecretion with or without duodenogastric reflux |
Gastric contents available for reflux are highly caustic to the esophagus due to high concentrations of acid and, with duodenogastric reflux, bile |
Extreme hypotension of the lower esophageal sphincter |
Impairment in primary antireflux barrier |
Poor esophageal contractility |
Reduced ability to clear esophagus of refluxed material |
Diminished esophageal pain sensitivity |
Reduced warning of esophageal injury which can also decrease compliance with antireflux therapy |
Decreased salivary secretion of epidermal growth factor |
May delay healing of esophagus |