Normal contractions of the esophagus regularly propel refluxed fluid from the esophagus back to the stomach. Abnormal esophageal motility will impair clearance of refluxed material and make GER more likely to be symptomatic and a problem. A third function important to GER is the motility of the stomach. Esophagitis is due to the reflux of gastric acid and digestive enzymes which erodes the lining of the esophagus. Esophagitis initially causes pain or irritability.
Pulmonary complications are due to a number of factors.
GER can cause bronchospasm and laryngospasm through a neurally-mediated reflex mechanism. GER can also lead to aspiration of stomach contents into the airway including the trachea, bronchi and alveoli. Aspiration may also be a cause of apnea in some cases. GER, especially while laying down, can contribute to sinus disease, nasal congestion, and ear infections by refluxing into the nasopharynx and causing inflammation. The possibility of GER as a cause of symptoms can be evaluated through a number of different methods.