Abstract
The function of the lower esophagus is discussed from a biomechanical point of view. The functional elements consist of the typical structure of the muscle fibers and of the construction of the opening to the stomach. In the active phase, the esophageal muscle fibers open the cardiac orifice, and during the resting stage, the normal longitudinal tension of the esophagus is responsible for closure. Biomechanical studies reveal the sliding hiatal hernia and reflux as momentary states in the pathomechanics of the lower esophagus. Hormonal regulation is unimportant. Based on biomechanical studies, a reasonable therapeutic approach is gastropexy.