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February 1985

Gastroesophageal Reflux: Pathophysiologic Concepts

Author Affiliations

From the Division of Gastroenterology, Department of Medicine (Drs Navab and Texter), and the Department of Physiology and Biophysics (Dr Texter), University of Arkansas for Medical Sciences, Little Rock.

Arch Intern Med. 1985;145(2):329-333. doi:10.1001/archinte.1985.00360020173027

Gastroesophageal reflux (GER), defined as reflux of gastric contents into the esophagus, is one of the most common problems occurring in clinical practice. In one study,1 a 36% occurrence of monthly heartburn was found in apparently healthy hospital personnel. Up to half of pregnant women complain of heartburn during the later stages of pregnancy. Since reflux occurs after meals and at other times in everyone, some degree of GER must be considered as a normal phenomenon. Indeed, there is spectrum between normal occasional reflux without symptoms to symptomatic reflux unaccompanied by esophagitis to reflux esophagitis with possible complications. Approximately 90% of patients with symptoms respond to conservative measures and drugs.2 Correct management of patients with GER is important to diminish consequences of esophagitis. Knowledge of the pathophysiologic mechanisms of GER is essential before recommending appropriate treatment.

CLINICAL FEATURES  Gastroesophageal reflux occurs in all age groups. Principal symptoms include

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