Document Detail

The role of esophageal motility and hiatal hernia in esophageal exposure to acid.
MedLine Citation:
PMID:  12163954     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The pathogenesis of gastroesophageal reflux disease (GERD) is multifactorial. This study evaluates the relationship between esophageal exposure to acid, the presence or absence of a hiatal hernia, and manometric indicators of esophageal motility. METHODS: A total of 51 patients with foregut symptoms were evaluated with upper gastrointestinal series or endoscopy, 24-h pH testing, and esophageal manometry. The DeMeester score was used to distinguish patients with physiologic reflux (DeMeester score <14.72) patients with pathologic reflux (DeMeester score >14.72). RESULTS: Patients with physiologic reflux had fewer hypotensive contractions and a smaller percentage of uncoordinated and hypotensive contractions combined, as compared to patients with pathologic reflux. The amplitude of distal esophageal contractions was greater in patients with physiologic reflux. Also, patients with a hiatal hernia had a higher incidence of pathologic reflux, regardless of the lower esophageal sphincter pressure. CONCLUSION: Patients with pathologic reflux have abnormal acid exposure associated with pump failure of the esophagus and/or a mechanical defect of the cardia associated with a hiatal hernia.
E S Xenos
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2002-02-27
Journal Detail:
Title:  Surgical endoscopy     Volume:  16     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-08-06     Completed Date:  2002-09-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  914-20     Citation Subset:  IM    
Department of Surgery, Lincoln County Memorial Center, 1000E Cherry Street, Troy, MO 63379, USA.
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MeSH Terms
Chi-Square Distribution
Esophagus / physiopathology
Gastric Acid
Gastroesophageal Reflux / etiology*,  physiopathology
Hernia, Hiatal / complications*
Hydrogen-Ion Concentration
Middle Aged

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

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