This relatively low frequency of BE in ZES patients despite the fact that they have chronic basal acid hypersecretion 4–8-fold higher that either idiopathic GERD patients or patients with idiopathic hypersecretion, combined with the finding that most ZES patients have normal esophageal motility [237], has led to the suggestion that ZES patients may have other protective factors such as increased EGF or bicarbonate section contributing to increased esophageal mucosal resistance to the high gastric acid levels [237]. Here, EGF is linked to Zollinger-Ellison syndrome.