Document Detail


New observations on the gastroesophageal antireflux barrier.
MedLine Citation:
PMID:  17950440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The use of high-frequency ultrasound transducers combined with manometry in the gastrointestinal (GI) tract has yielded important findings concerning the anatomy, physiology, and pathophysiology of the high-pressure zone of the gastroesophageal junction and the sphincteric muscles within. These transducers have made previously invisible portions of the GI tract accessible to investigation. Three distinct high-pressure zones have been identified and correlated with anatomic structures: the extrinsic sphincter (crural diaphragm) and the two components of the intrinsic sphincter (an upper LES and a lower LES [the gastric sling fiber/clasp fiber complex]). This article discusses the possible underlying pathophysiology of gastroesophageal reflux disease; the biomechanics of the gastroesophageal junction high-pressure zone; and the mechanism of action of standard surgical and newer endoscopic therapies for gastroesophageal reflux disease.
Authors:
Larry Miller; Anil Vegesna; Amit Kalra; Ramashesai Besetty; Qing Dai; Annapurna Korimilli; James G Brasseur
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Gastroenterology clinics of North America     Volume:  36     ISSN:  0889-8553     ISO Abbreviation:  Gastroenterol. Clin. North Am.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-10-22     Completed Date:  2008-01-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706257     Medline TA:  Gastroenterol Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  601-17, ix     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Temple University Hospital, Gastroenterology Section, 8th Floor, Parkinson Pavilion, Philadelphia, PA 19043, USA. vivi@temple.edu
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MeSH Terms
Descriptor/Qualifier:
Biomechanics
Endoscopy, Gastrointestinal / methods*
Endosonography / methods*
Esophageal Sphincter, Lower / physiopathology,  ultrasonography
Fundoplication / methods*
Gastroesophageal Reflux* / diagnosis,  physiopathology,  surgery
Gastrointestinal Motility / physiology
Humans
Manometry
Pressure
Prognosis
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
R01-DK-59500/DK/NIDDK NIH HHS

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


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