contd.

,
• Sliding Hiatus Hernia.
•Alteration of Phreno esophageal Ligament.
•Altered Obliquity of GE junction.V M C
•Altered Obliquity of GE junction.
• •Reduced pinching action of Crus of Diaphragm.
•Reduced LES Pressure.
•Altered Transient Relaxation period in LES
•Raised Intra Abdominal Pressure.V M C Pressure.
•Raised Intra Gastric Pressure.
•Gastric Acid Hypersecretion
• Fundic distention (overeating) & delayed gastric emptying (high fat) •
Lower esophageal sphincter is pulled distally by expanding fundus V
M C • Squamous epithelium exposed to gastric juice • Repeated
exposure columnarization
• 12. S V PathophysiologyPathophysiology of GERDof GERD •Extension
of inflammation into muscularis propria causes progressive loss in
length and pressure of the LES— “esophageal shortening” V M C •
Loss of LES leads to regurgitation, heartburn, and subsequent severe
esophagitis
• 13. S V PathophysiologyPathophysiology of GERDof GERD •Spectrum
of disease theory: Nonerosive disease erosive disease Barrett’s
esophageal adenocarcinoma V M C esophageal adenocarcinoma
contd.,
•Peptic Ulceration
•Hemetemesis
•Stricture Esophagus
•V M C •Barrett’s esophagus
•Adeno Carcinoma esophagus
•Laryngeal Complications
•Respiratory Complications