What pathophysiological feature leads to reflux symptoms in GERD?

What pathophysiological feature leads to reflux symptoms in GERD?

• A. Relaxation or incompetence of the lower esophageal sphincter allowing reflux of gastric contents into the esophagus.
• B. Increased tone of the lower esophageal sphincter preventing reflux.
• C. Delayed gastric emptying reduces reflux.
• D. Esophageal motility disorders that block reflux.

Answer: (A)

Reflux in GERD mainly happens when the barrier at the gastroesophageal junction fails to stay closed because the lower esophageal sphincter loses tone or relaxes inappropriately. The LES normally acts as a one-way valve, preventing stomach contents from moving back up into the esophagus. When it relaxes or becomes incompetent, gastric acid and other contents can reflux into the esophagus, triggering symptoms like heartburn and potential mucosal injury. Increased LES tone would actually prevent reflux, so that option isn’t the cause. Delayed gastric emptying can worsen reflux by increasing gastric volume, not reduce it, and esophageal motility disorders can affect clearance of refluxate but aren’t the primary mechanism initiating reflux.

Reflux in GERD mainly happens when the barrier at the gastroesophageal junction fails to stay closed because the lower esophageal sphincter loses tone or relaxes inappropriately. The LES normally acts as a one-way valve, preventing stomach contents from moving back up into the esophagus. When it relaxes or becomes incompetent, gastric acid and other contents can reflux into the esophagus, triggering symptoms like heartburn and potential mucosal injury. Increased LES tone would actually prevent reflux, so that option isn’t the cause. Delayed gastric emptying can worsen reflux by increasing gastric volume, not reduce it, and esophageal motility disorders can affect clearance of refluxate but aren’t the primary mechanism initiating reflux.