The pathogenesis of gastroesophageal reflux disease (GERD) is complex and involves changes in reflux exposure, epithelial resistance, and visceral sensitivity. The gastric refluxate is a noxious material that injures the esophagus and elicits symptoms. Esophageal exposure to gastric refluxate is the primary determinant of disease severity. This exposure arises via compromise of the anti-reflux barrier and reduced ability of the esophagus to clear and buffer the refluxate, leading to reflux disease. However, complications and symptoms also occur in the context of normal reflux burden, when there is either poor epithelial resistance or increased visceral sensitivity. Reflux therefore develops via alterations in the balance of aggressive and defensive forces.

胃食管反流病（GERD）的发病机制很复杂，涉及反流暴露，上皮抵抗力和内脏敏感性的变化。胃回流是一种有害物质，会伤害食道并引起症状。食道胃反流暴露是疾病严重程度的主要决定因素。这种暴露是通过抗反流屏障的破坏和食道清除和缓冲回流物的能力降低而引起的，从而导致回流病。但是，当上皮抵抗力较差或内脏敏感性增加时，在正常的反流负担中也会出现并发症和症状。因此，反流是通过改变攻击力和防御力之间的平衡来发展的。