Table 1.

Summary of the pathogenesis of gastroesophageal reflux disease

Main underlying mechanism	Associated conditions	Mechanism of GERD
Anatomical defect	Hiatus hernia, immature esophageal anti-relux barrier, e.g., infants, surgical pull up for esophageal atresia	Increased risk of GER
Esophageal or gastric hypomotility/dysmotility	Esophageal disorders associated with dysmotility, e.g., esophageal atresia, achalasia, gastroparesis, cow’s milk protein allergy, sleeping, decreased saliva secretion, supine position	Impaired esophageal clearance of refluxate by peristalsis and/or production of neutralizing secretions
Esophageal mucosal defect	Eosinophilic esophagitis, esophageal infection	Impaired esophageal sensation
UES dysfunction	Extraesophageal or respiratory manifestations	Allows refluxate to access airways

GERD: Gastroesophageal reflux disease; UES: Upper esophageal sphincter.