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Gastroesophageal reflux disease (GERD) - Causes
Medical expert of the article
Alexey Kryvenko, Medical Reviewer, Editor
Last reviewed: 06.07.2025
Last reviewed: 06.07.2025
Causes of gastroesophageal reflux disease:
The following factors contribute to the development of hypotension of the lower esophageal sphincter:
- consumption of products containing caffeine (coffee, tea, Coca-Cola), as well as medications that contain caffeine (citramon, caffetamine, etc.);
- taking peppermint;
- taking medications that reduce the tone of the lower esophageal sphincter (calcium antagonists, papaverine, no-shpa, nitrates, baralgin, anticholinergics, analgesics, theophylline, doxycycline);
- vagus nerve damage (vagal neuropathy in diabetes mellitus, vagotomy);
- smoking (nicotine significantly reduces the tone of the lower esophageal sphincter);
- alcohol consumption (this not only reduces the tone of the lower esophageal sphincter, but also has a damaging effect on the mucous membrane of the esophagus and the sphincter itself);
- pregnancy (hypotension of the lower esophageal sphincter in this case is caused by the influence of hormonal factors - high estrogenemia and progesteronemia; an increase in intra-abdominal pressure during pregnancy also plays a role in the development of GERD).
- Dysfunction of the lower esophageal sphincter (cardiac insufficiency), decreased esophageal clearance, damaging properties of refluxate (hydrochloric acid, pepsin, bile acids), inability of the esophageal mucosa to resist damaging effects.
- Dysfunction of the lower esophageal sphincter may be a consequence of a primary defect in the smooth muscles of the sphincter, a hernia of the esophageal opening of the diaphragm.
- Other causes of cardiac insufficiency include scleroderma, pregnancy, smoking, and the use of drugs that reduce smooth muscle tone (nitrates, calcium channel blockers, aminophylline).
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