Disease Etiology
Gastroesophageal reflux (GER) occurs with transient relaxation of the lower esophageal sphincter or inadequate adaptation of the sphincter tone to changes in abdominal pressure (1). The progression to gastroesophageal reflux disease (GERD) only occurs when reflux results in symptoms and/or complications. GERD may be classified as primary or secondary. Primary GERD is characterized by regurgitation and emesis. It occurs in isolation and is not associated with other disease