Reflux esophagitis is prevented by
A. Long intraabdominal esophagusB. Increased intraabdominal pressure
C. Right crus of diaphragm
D. Increased intrathoracic pressure
E. All of above
Answer (A) Long intraabdominal esophagus;
(C) Right
crus of diaphragm;
(D) Increased intrathoracic pressure
• The anti-reflux mechanisms are (GERD protective):
— Lower esophageal splincter
— Anatomic location of Gastroesophageal junction below
the diaphragmatic hiatus.
— The crural diaphragm (rt crus).
— The oblique entry, of Lower esophagus into stomach.
— Gravity, intrathoracic pressure prevents reflux of
the gastric content to esophagus.
• Reflux occurs when weakness of LES, high
intra-abdominal pressure, delayed gastric emptying, incr. gastric volume
Complications include — Esophagitis, peptic stricture,
and Barret’s esophagus.
Reflux esophagitis best diagnosed by endoscopy also by
Ba Swallow, mucosal biopsy.
24 hr pH
recording
is the Gold standard for diagnosis of GERD.
