Document Detail

Mechanisms of excessive esophageal acid exposure in patients with reflux esophagitis.
MedLine Citation:
PMID:  19005757     Owner:  NLM     Status:  MEDLINE    
The pathophysiology of excessive esophageal acid exposure, including the way refluxed acid extends towards the proximal esophagus, in patients with reflux esophagitis (RE), is not yet clear. For 3 h after a meal, concurrent esophageal manometry and pH monitoring was carried out on 14 patients with severe RE, 15 patients with mild RE, and 15 healthy subjects. At 2 cm above the proximal margin of the lower esophageal sphincter (LES) there was no difference between the three groups in the total number of acid-reflux episodes, the rate of transient LES relaxations (TLESRs), or the rate of acid reflux during TLESRs. The rate of acid reflux at 7 cm above the proximal margin of the LES, during TLESRs, in patients with severe RE (50.9%, median) was, however, significantly higher than in patients with mild RE (35.7%) and healthy subjects (15.4%). In addition, the rate of acid reflux during TLESRs in patients with mild RE was significantly higher than in healthy subjects. Both the amplitude and the success rate of primary peristalsis in patients with severe RE were significantly lower than those of healthy subjects and patients with mild RE but there was no difference between healthy subjects and patients with mild RE. The cause of excessive acid exposure in patients with RE is the difference in the way refluxed acid extends towards the proximal esophagus and acid bolus clearance, not the number of acid-reflux episodes.
Katsuhiko Iwakiri; Noriyuki Kawami; Hirohito Sano; Yuriko Tanaka; Mariko Umezawa; Makoto Kotoyori; Yoshio Hoshihara; Choitsu Sakamoto
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Publication Detail:
Type:  Journal Article     Date:  2008-11-13
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  54     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-06-29     Completed Date:  2009-07-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1686-92     Citation Subset:  AIM; IM    
Department of Medicine, Division of Gastroenterology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo, 113-8603, Japan.
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MeSH Terms
Case-Control Studies
Esophageal Sphincter, Lower / physiopathology
Esophageal pH Monitoring
Esophagitis, Peptic / complications*,  physiopathology*
Esophagus / physiopathology
Gastroesophageal Reflux / etiology*,  physiopathology*
Inflammation / physiopathology
Middle Aged

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

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