Fig 1. Penetrated PA chest x-ray demonstrating a retrocardiac opacity with air fluid level (blue arrow): moderate hiatus hernia. Reflux of gastric contents into the oesophagus may occur during intermittent relaxation of the lower oesophageal sphincter (LOS). Occasionally there is free reflux through an incompetent LOS, sometimes associated with a hiatus hernia. Dr Michael Prichard, Respiratory Physician Reflux into the lower oesophagus when upright is cleared readily by swallowing, peristalsis, gravity. Local mucosal factors help protect against intermittent acid injury (epithelial lining fluid and saliva, carbonic anhydrase). Reflux symptoms (regurgitation, belching, heartburn) are common and not necessarily pathological. However, recurrent…
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