Pathophysiology of reflux esophagitis

Reflux esophagitis is more frequent in developed countries, and its prevalence increased in Japan in these 1/4 centuries. These increase might be based on the increase in the population of the elderly, advances in endoscopic technology, increase in the interest on esophagitis, and declined prevalence of Helicobacter pylori infection. Main pathogenesis on the reflux esophagitis are classified as 2 components. One is the motility factor of the stomach and the esophagus. Distention of the stomach causes transient LES relaxation(TLESR), leading acid reflux into the esophagus. Delayed gastric emptying enhances gastric distention, causing TLESR. Resting LES pressure might be lower than normal. Hiatal hernia is also an exaggerating factor, causing repeated reflux from the hernia sac. The other main cause is the intact acid secretion causing enough to injure the esophageal mucosa. Gastric atrophy due to Helicobacter pylori infection would be protective factor for reflux esophagitis.