| Effect of prolonged gastric distention on lower esophageal sphincter function and gastroesophageal reflux. | |
| | |
MedLine Citation:
|
PMID: 12907321 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: Morbidly obese patients treated with an intragastric balloon report a transient increase in gastroesophageal reflux (GER) symptoms. In the present study, we evaluated the underlying mechanisms of GER and examined the effect of prolonged gastric distention on lower esophageal sphincter function. METHODS: Fasting and postprandial manometric studies were performed in obese subjects (n = 15) before, immediately after, and 10 and 20 wk after placement of a 500-ml water-filled balloon. RESULTS: Residual lower esophageal sphincter (LES) pressure after water swallows was not affected after balloon placement, excluding mechanical interaction with sleeve function. Postprandial LES pressure was significantly increased after 10 and 20 wk. GER was increased in the right recumbent position until 10 wk after balloon placement, mainly because of an increased percentage of transient lower esophageal sphincter relaxations (TLESRs) accompanied by GER. TLESRs were the main mechanisms underlying reflux both before and after balloon placement. The rate of TLESRs was increased significantly immediately after introduction of the balloon, returning to baseline values after 20 wk. After balloon placement, reflux episodes were evoked by gastric contractions that were not inhibited by meals. CONCLUSIONS: Chronic distention by an intragastric balloon increased reflux up to 10 wk after placement because of an increase in the percentage of TLESRs accompanied by a reflux episode. In addition, prolonged balloon distention increased the rate of TLESRs and created a postprandial state even 10 wk after balloon placement. After 20 wk these effects largely resolved, illustrating adaptation to this artificial situation. |
| | |
Authors:
|
D P Hirsch; E M H Mathus-Vliegen; U Dagli; G N J Tytgat; G E E Boeckxstaens |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The American journal of gastroenterology Volume: 98 ISSN: 0002-9270 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2003 Aug |
Date Detail:
|
Created Date: 2003-08-08 Completed Date: 2003-09-29 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
|
Languages: eng Pagination: 1696-704 Citation Subset: IM |
Affiliation:
|
Division of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Esophagogastric Junction / physiology*, physiopathology Gastric Balloon / adverse effects Gastric Dilatation / etiology, physiopathology* Gastroesophageal Reflux / complications, physiopathology* Humans Middle Aged Muscle Relaxation / physiology Obesity / complications, therapy Prospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Effects of gender and age on esophageal biomechanical properties and sensation.
Next Document: Hypertrophy of the muscularis propria of the lower esophageal sphincter and the body of the esophagu...