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GERD - Coggle Diagram

- - - - Angle of His= oblique entrance of esophagus into stomach
      - phrenoesophageal ligament
      - striated muscles of crural diaphragm
      - lower esophageal sphincter
      - attachment of LES to crural diaphragm
    - - volume clearance by peristaltic function
      - neutralization of acid by bicarbonate in the swallowed saliva
    - - Epithelial Defense
        
        cell membranes and tight intercellular junctions, buffers, and ion transporters
      - Pre-Epithelial Barrier
        
        small unstirred water layer
        
        bicarbonate from swallowed saliva
        
        secretions of submucosal glands
      - Post epithelial Defense
        
        blood supply to the esophagus
  - - - impaired peristalsis
      - reduced salivation
        
        smokers, Sjogren's syndrome
      - body position
    - - Gastric Outlet Obstruction
      - Anticholinergics
      - Fatty Foods
    - - Hiatus Hernia
      - LES Abnormalities (reduced tone)
        
        smoking, alcohol, caffeine, fatty foods, vagotomy, beta agonists, nitrates, CCBs
      - Raised Intra-Abdominal Pressure
        
        pregnancy, obesity, ascites, weight lifting/straining