Gastroenterology

p {margin: 0; padding: 0;} Gastroenterology Gastroesophageal reflux The abdominal esophagus measures 1 to 2.5 centimeters in length and opens into the stomach at the level of the cardia which is located approximately 40 cm from the incisors. Among the formations involved in the creation of anti-reflux barriers, the lower esophageal sphincter (made up of smooth muscle fibers) plays a preponderant role. The esophageal lumen is lined with non-keratinized stratified squamous epithelium (like that of the oropharynx). Pale pink in color at endoscopy, it continues through the glandular epithelium of the stomach, more reddish, from a transition zone called the Z line. Gastroesophageal reflux is a pathological reflux of part of the gastric contents (hydrochloric acid, pepsin), or even intestinal contents (bile, pancreatic enzymes) into the esophagus. All forms combined, it affects 40% of the population on a monthly basis (7 to 10% on a daily basis). Inappropriate transient relaxations of the lower esophageal sphincter-The lower esophageal sphincter opens normally after swallowing. Its inappropriate transient relaxations occur without swallowing and can persist for up to 2 hours. This phenomenon is the main mechanism explaining gastroenterology reflux (90% of cases). Hiatal hernias-These are intermittent or permanent protrusions of part of the stomach into the thorax through the esophageal hiatus of the diaphragm. There are two types: sliding hernias and rolling hernias. Sliding hiatal hernias, which are the most common (95% of hiatal hernias), are defined by the passage of the abdominal esophagus, the cardia and the greater gastric tuberosity into the mediastinum. During a rolling hiatal (or paraesophageal) hernia, only the large gastric tuberosity is found in the thorax. Of these two types of hiatal hernias, only sliding hernias cause gastroesophageal reflux.