Document Detail


Increased intragastric pressure gradients are involved in the occurrence of acid reflux in gastroesophageal reflux disease.
MedLine Citation:
PMID:  19191069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Increased pressure gradients across the esophagogastric junction (DeltaEGJp) play a role in gastroesophageal flow during TLESR. The aim of this study was to further explore DeltaEGJp in patients with gastroesophageal reflux disease (GERD) and controls. MATERIAL AND METHODS: Twenty GERD patients were studied along with 20 control subjects. High resolution manometry and pH recording were performed 1 h before and 2 h after a liquid meal (500 ml/300 kcal). DeltaEGJp was calculated at the start of a TLESR and at 180, 60, and 10 s before TLESR. RESULTS: DeltaEGJp at the start of a TLESR and at 180, 60, and 10 s before TLESR was markedly increased in GERD patients compared with that in control subjects (9.9 mmHg and 7.5 mmHg, respectively; p<0.05). Whilst intragastric pressure gradients in GERD patients were increased compared with those in controls (4.6 mmHg and 2.5 mmHg, respectively; p<0.01), intraesophageal pressure gradients were similar in both groups. Furthermore, in controls, first- and second-hour postprandial intragastric pressures were decreased compared with in fasting periods (1.9 +/- 0.4 mmHg and 2.1 +/- 0.4 mmHg versus 3.5 +/- 0.4 mmHg; p<0.05), while this was not observed in GERD patients. CONCLUSIONS: In GERD patients, DeltaEGJp is greater than that in controls both before and during TLESR. This phenomenon is caused by increased intragastric pressure and might contribute to increased rates of acid reflux during TLESR in GERD patients.
Authors:
Rutger Frankhuisen; Margot A Van Herwaarden; Robert Ch Scheffer; Geoffrey S Hebbard; Hein G Gooszen; Melvin Samsom
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  44     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2009  
Date Detail:
Created Date:  2009-04-28     Completed Date:  2009-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  545-50     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, University Medical Center Utrecht, Utrecht, The Netherlands. rutgerfrankhuisen@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Case-Control Studies
Esophageal Sphincter, Lower / physiopathology*
Esophageal pH Monitoring
Esophagogastric Junction / physiopathology*
Female
Gastric Acid / metabolism*
Gastroesophageal Reflux / diagnosis*
Humans
Male
Manometry / methods*
Middle Aged
Muscle Relaxation / physiology*
Pressure
Probability
Reference Values
Sensitivity and Specificity

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


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