A 50-year-old woman presents with symptoms of heartburn due to a weak lower esophageal sphincter. Which of the following conditions causes this?
  1. Achalasia
  2. Mallory-Weiss syndrome
  3. Hiatal hernia
  4. Gastroesophageal reflux disease
Explanation
Answer - D - Gatroesophageal reflux disease, or GERD, is the backflow of gastric and duodenal contents into the esophagus. The primary symptom is heartburn due to the acid refluxing into the esophageal lining. Other symptoms mimic the feeling of heart attack.

Mallory-Weiss syndrome is characterized by esophageal bleeding due to a mucosal tear in the esophagus as a result of forceful vomiting. Hiatal hernia is the protrusion of the upper part of the stomach due to a weakness in the diaphragm. Achalasia is an abnormality in the esophagus resulting in the inability of the food or fluid to pass through the lower end of the sphincter into the stomach.
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