Pathophysiology of GERD in China: the same factors at a lower scale

Most of the factors involved in the pathogenesis of gastroesophageal reflux disease (GERD), previously described in European, Australian, and American studies, are present in Chinese patients with GERD, but at a lower scale. The acidity of gastric contents is reduced either spontaneously or by Helicobater pylori infection. A low-fat diet probably contributes to a more favorable gastric distribution of the meals, reduced obesity, and lowers the number of TLESRs. The prevalence of hiatal hernia is low and esophageal motility disorders are moderate. Like in Western countries, the pathophysiology of GERD in China is multifactorial, with variable combination of moderate abnormalities in individual patients, leading to milder forms of GERD.