ABSTRACT
In an attempt to elucidate the etiological factors that contribute to gastroesophageal reflux disease (GERD), it is necessary to have a full understanding of normal diaphragmatic anatomy and physiology. Pathological reflux occurs when there are anatomical and physiological abnormalities at the gastroesophageal junction and crura. These abnormalities are influenced by postural changes and gradients between intra-abdominal and intrathoracic pressures. Corrective surgery must include a proper diaphragmatic repair in order to minimize the potential for recurrence. Postoperative management must be tailored to the patient’s age, the size of the hiatal defect, and the patient’s lifestyle.
