Overview of pathophysiological features of GERD.
Level 5 - mechanism / opinion, no new human data
Narrative review of disease mechanisms without systematic synthesis or primary data
PubMed 28251844 · doi:10.23736/S1121-421X.17.02390-X
What was done
The author reviewed the complex and multifactorial pathophysiological mechanisms underlying gastroesophageal reflux disease (GERD), including motor dysfunction, anatomical abnormalities, mucosal integrity, sensory perception, and clinical risk factors.
What was found
The abstract reports no numerical data. Qualitatively, GERD pathophysiology involves decreased salivation, reduced lower esophageal sphincter resting tone, transient sphincter relaxations, hiatal hernia, hypersecretion of acid/pepsin, duodeno-gastro-esophageal reflux, impaired clearance, and delayed gastric emptying. Mucosal integrity is impaired in both non-erosive reflux disease (NERD) and erosive esophagitis (including macroscopically normal regions), but remains normal in functional heartburn. Symptom perception is modulated by reflux acidity, proximal extent, gas content, and visceral hypersensitivity.
Why it matters
Understanding the diverse physiological, mucosal, and neurosensory pathways in GERD helps differentiate true reflux phenotypes from functional heartburn and informs targeted therapeutic approaches.
Limits
The abstract does not provide systematic review methodology, search criteria, study selection processes, or quantitative data. As a broad narrative overview, it lacks primary empirical evidence.
Cited by
- contradicts Normal stomach acidity has a pH between 1.5 and 3.0, and elevated stomach pH causes the lower esophageal sphincter valve to fail to close properly.