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## Physiologic Reflux Awake and upright > asleep and supine ** * T/F: Reflux is more common in awake and upright position than during sleep and supine position ### How: * physiologic reflux / Sucking is more pronounced in upright position * Unguarded moments (swallow-induced) ✓ * Pressure gradient...

## Physiologic Reflux Awake and upright > asleep and supine ** * T/F: Reflux is more common in awake and upright position than during sleep and supine position ### How: * physiologic reflux / Sucking is more pronounced in upright position * Unguarded moments (swallow-induced) ✓ * Pressure gradients (12-mmHg pressure gradient) * The thoracic negative pressure is higher than the abdominal pressure * LES pressure ## Assessment to Esophageal Function * Tests to detect structural abnormalities of the esophagus * Tests to detect functional abnormalities of the esophagus * Tests to detect increased esophageal exposure to gastric juice * Tests of duodenogastric function as they relate to esophageal disease ## Structural Abnormalities * **Endoscopic evaluation** * assessment and biopsy** * Dysphagia * Flexible fiberoptic esophagoscope vs. rigid endoscopy * In GERD: Esophagitis and Barrett's CLE (columnar-lined esophagus)