| Oesophageal sensation in response to high PCO(2) and acidic solutions in nonerosive reflux disease. | |
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MedLine Citation:
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PMID: 21679182 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Eur J Clin Invest 2011 ABSTRACT: Background Heartburn is commonly associated with the presence of acid in the oesophageal lumen. However, in patients with nonerosive reflux disease (NERD), the mechanism by which acid traverses the mucosa is not clear. We hypothesized that the luminal acid signal traverses the oesophageal epithelium in the form of the highly permeant gas CO(2) , which then is reconverted to H(+) in the submucosa. Materials and methods Ten patients with heartburn, normal upper endoscopy and increased oesophageal acid exposure (NERD patients) and 10 healthy subjects were enrolled. Perceptual responses to intraoesophageal acid (0·1 N HCl solution) and a high PCO(2) solution were determined using a randomized cross over design. Stimulus-response functions to perfusions were quantified by three parameters: lag time to symptom perception, intensity rating and perfusion sensitivity score. Results In NERD patients, the difference in lag time to typical symptom perception, intensity rating and perfusion sensitivity score between high PCO(2) and acid perfusions was statistically significant (P = 0·02, 0·01 and 0·02, respectively). However, the difference in the same perfusion parameters between acid and high PCO(2) perfusions was nonsignificant in healthy controls. When NERD and controls were compared, the difference between the different perfusion variables was nonsignificant (adjusted to age). Conclusions In NERD subjects, acid perfusion reliably evoked heartburn symptoms of greater intensity than in healthy controls. Nevertheless, a high PCO(2) perfusion failed to produce symptoms in either group. |
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Authors:
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Tiberiu Hershcovici; Choo H Poh; Ofer Z Fass; Nicole Ashpole; Yasutada Akiba; Jose M Guillén-Rodríguez; Jonathan D Kaunitz; Ronnie Fass |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-25 |
Journal Detail:
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Title: European journal of clinical investigation Volume: - ISSN: 1365-2362 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-6-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0245331 Medline TA: Eur J Clin Invest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation. |
Affiliation:
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The Neuroenteric Clinical Research Group, Section of Gastroenterology, Southern Arizona VA Health Care System and University of Arizona Health Sciences Center, Tucson, AZ, USA Greater Los Angles Veterans Affairs Healthcare System, Department of Medicine, School of Medicine, University of California Los Angeles, and Brentwood Biomedical Research Institute, Los Angeles, CA, USA University of Arizona, Arizona Cancer Center, Tucson, AZ, USA. |
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