True about early stages of GERD

In normal circumstances, the LOS transiently relaxes as a coordinated pa of swallowing, as a means of allowing vomiting to occur and in response to stretching of the gastric fundus, paicularly after a meal to allow swallowed air to be vented. Most episodes of physiological reflux occur during postprandial transient LOS relaxations (TLOSRs). In the early stages of GORD, most pathological reflux occurs as a result of an increased number of TLOSRs rather than a persistent fall in overall sphincter pressure. In more severe GORD, LOS pressure tends to be generally low, and this loss of sphincter function seems to be made worse if there is loss of an adequate length of intraabdominal oesophagus.Ref: Bailey and Love 27e pg: 1076