Document Detail


Effect of hyperglycemia on triggering of transient lower esophageal sphincter relaxations.
MedLine Citation:
PMID:  15068963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute changes in blood glucose concentration have major effects on gastrointestinal motor function. Patients with diabetes mellitus have an increased prevalence of gastroesophageal reflux. Transient lower esophageal sphincter (LES) relaxation (TLESR) is the most common sphincter mechanism underlying reflux. The aim of this study was to investigate the effect of acute hyperglycemia on triggering TLESRs evoked by gastric distension in healthy volunteers. TLESRs were stimulated by pressure-controlled and volume-controlled (500 ml) gastric distension using an electronic barostat and performed on separate days. On each day, esophageal manometry was performed in the sitting position during gastric distension for 1 h under euglycemia (5 mM), and either marked hyperglycemia (15 mM) or physiological hyperglycemia (8 mM) in randomized order was maintained by a glucose clamp. Marked hyperglycemia doubled the rate of TLESRs in response to both pressure-controlled [5 (3-10.5, median or interquartile range) to 10 (9.5-14.5) per hour, P < 0.02] and volume-controlled [4 (2.5-7.5) to 10.5 (7-12.5) per hour, P < 0.02] gastric distension but had no effect on basal LES pressure. Physiological hyperglycemia had no effect on the triggering of TLESRs or basal LES pressure. In healthy human subjects, marked hyperglycemia increases the rate of TLESRs. Increase in the rate of TLESRs is independent of proximal gastric wall tension. Mechanisms underlying the effect remain to be determined. Hyperglycemia may be an important factor contributing to the increased esophageal acid exposure in patients with diabetes mellitus.
Authors:
Qing Zhang; Michael Horowitz; Rachael Rigda; Christopher Rayner; Andrew Worynski; Richard H Holloway
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  286     ISSN:  0193-1857     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-07     Completed Date:  2004-05-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G797-803     Citation Subset:  IM    
Affiliation:
Dept. Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Balloon Dilatation
Esophagogastric Junction / physiopathology*
Female
Glucose Clamp Technique
Humans
Hyperglycemia / physiopathology*
Male
Manometry
Middle Aged
Muscle Relaxation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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