Gastroesophageal reflux occurs in everyone and in the large majority it remains a benign event, producing neither symptoms nor signs of disease. The reason for this is the presence of a three-tiered esophageal defense that is poised to: (1) minimize the frequency of reflux events (antireflux barriers such as the lower esophageal sphincter), (2) minimize the duration of contact between esophageal epithelium and noxious elements in the refluxate (luminal clearance mechanisms), and (3) minimize the impact and damage to the tissue during the time of contact with the noxious elements in the refluxate (Fig. 1).
KeywordsBile Salt Lower Esophageal Sphincter Aluminum Hydroxide Reflux Esophagitis Esophageal Mucosa
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