Highlights of the physiopathology of gastroesophageal reflux

: Manometric studies have shown that the principal barrier against gastro-oesophageal reflux is the inferior oesophageal sphincter. The factors capable of physiologically and pathologically modifying the sphincter pressure are analysed. Other factors may be involved as well as a decrease in the pressure of the inferior oesophageal sphincter: the length of the abdominal oesophagus, the oesophageal clearance, delayed gastric emptying, duodeno-gastric reflux. Thus, in many patients, gastro-oesophageal reflux reflects a disturbance of the motility of the upper gastrointestinal tract and not just the oesophagus.