Aetiology with respect to mechanism
- raised intra-abdominal pressure, e.g. obesity, eating large meals, tight clothing, pregnancy
- faulty oesophageal sphincter, e.g. pregnancy - due to hormonal smooth muscle relaxation, smoking, fatty meals, hiatus hernia, after surgery for achalasia
- drugs, e.g. tricyclic depressants, anticholinergics which affect the function of the lower oesophageal sphincter
Acidic damage to the lower oesophageal mucosa can cause reflex longitudinal muscle spasm. This draws the cardia upwards, so further permitting acid reflux.
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