Pathophysiology of gastro-oesophageal reflux disease.

摘要: Gastro-oesophageal reflux disease is a condition in which the of gastric contents into oesophagus provokes symptoms or complications and impairs quality life. Typical gastro-oesophageal are heartburn regurgitation but has also been related to extra-oesophageal manifestations, such as asthma, chronic cough laryngitis. The pathogenesis multifactorial, involving transient lower oesophageal sphincter relaxations other pressure abnormalities. As result, acid, bile, pepsin pancreatic enzymes occurs, leading mucosal injury. Other factors contributing pathophysiology include hiatal hernia, impaired clearance, delayed emptying defensive factors. Hiatal hernia contributes by promoting dysfunction. Impaired clearance responsible for prolonged acid exposure mucosa. Delayed emptying, resulting distension, can significantly increase rate relaxations, postprandial disease. play an important role against development disease, neutralizing backdiffusion hydrogen ion tissue. While now well known, mechanisms underlying airway manifestations still poorly understood. Two hypotheses have proposed: direct contact with upper vago-vagal reflex elicited acidification distal oesophagus, bronchospasm. In conclusion, be considered result complex interplay factors, all acidic mucosa, different degrees damage.