Gastroesophageal Reflux Disease

[Alde8127]

Why is gastroesophageal reflux disease worse when lying down or bending over? Is it because the LES is even weaker in these positions, and esophageal motility is reduced, leading to more reflux in these postions?

Also, since the pain is retrosternal, does that mean its somatic rather than visceral pain?

Thanks

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[Alde8127]

Gravity; When you lie down, the esophageal sphincter is in a more dependent position than while standing up, and any fluid (acid) sitting around has a greater likelihood of refluxing cross the weak sphincter.

Thanks!
What about the pain - I thought it was due to the anterior wall of the thoracic cage being irritated and so its somatic?

 

[Alde8127]

I'm pretty sure that there are pain and temperature receptors in the esophagus, so if that's what you're referring to when you say somatic, as in direct pain and not referred, then yes. But if by somatic you mean direct irritation of muscles or referred pain, then no.

Thank you - I think I was overcomplicating it.