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[Effects of two test-meals on transient lower esophageal sphincter relaxation in patients with gastroesophageal reflux disease and mechanism of gastroesophageal reflux].

Abstract

OBJECTIVE

To investigate the effects of standard meal and fat meal distending the fundus on transient lower esophageal sphincter relaxation (TLESR) and esophageal motility and to explore the mechanism of gastroesophageal reflux (GER) in patients with gastroesophageal reflux disease (GERD).

METHODS

Eight patients with GERD (3 male, 5 female; median age: 43.5 ys) were enrolled in the study. All received 2 times of esophageal manometry and pH monitoring simultaneously for 30 min during fasting and 2 h after two different test-meals, including standard meal (SM) and fat meal (FM) on separate day at least 1 week apart.

RESULTS

The frequency of TLESR significantly increased after 2 test-meals (P < 0.05). There were no significant difference in the frequency and duration of TLESR between SM group and FM group 1 h after meal (P > 0.05). However, the frequency of TLESR in FM group 2 h after meal was more than that in SM group and during fasting (P < 0.05). Lower esophageal sphincter pressure (LESP) significantly decreased in FM group than in SM group (P < 0.05). The contractive amplitude of post lower esophageal sphincter relaxation and the contractive amplitude of the distal esophagus had no difference after FM and SM. Acid reflux episodes and duration of pH < 4 were larger after FM than after SM (P < 0.05). A total of 50.2% of GER occurred during decreased LESP and 37.8% during TLESR after FM, while 61.7% of GER occurred during TLESR after SM.

CONCLUSIONS

Both the SM and FM can increase the frequency of TLESR in patients with GERD. Decreased LESP and increased frequency of TLESR after FM are the major mechanism of GER, while reflux after SM may attribute to the increased frequency of TLESR.

Authors+Show Affiliations

Department of Gastroenterology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

15663221

Citation

Sun, Xiao-Hong, et al. "[Effects of Two Test-meals On Transient Lower Esophageal Sphincter Relaxation in Patients With Gastroesophageal Reflux Disease and Mechanism of Gastroesophageal Reflux]." Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae, vol. 26, no. 6, 2004, pp. 628-33.
Sun XH, Ke MY, Wang ZF, et al. [Effects of two test-meals on transient lower esophageal sphincter relaxation in patients with gastroesophageal reflux disease and mechanism of gastroesophageal reflux]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2004;26(6):628-33.
Sun, X. H., Ke, M. Y., Wang, Z. F., & Liu, X. H. (2004). [Effects of two test-meals on transient lower esophageal sphincter relaxation in patients with gastroesophageal reflux disease and mechanism of gastroesophageal reflux]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae, 26(6), pp. 628-33.
Sun XH, et al. [Effects of Two Test-meals On Transient Lower Esophageal Sphincter Relaxation in Patients With Gastroesophageal Reflux Disease and Mechanism of Gastroesophageal Reflux]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2004;26(6):628-33. PubMed PMID: 15663221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effects of two test-meals on transient lower esophageal sphincter relaxation in patients with gastroesophageal reflux disease and mechanism of gastroesophageal reflux]. AU - Sun,Xiao-Hong, AU - Ke,Mei-Yun, AU - Wang,Zhi-Feng, AU - Liu,Xiao-Hong, PY - 2005/1/25/pubmed PY - 2006/5/24/medline PY - 2005/1/25/entrez SP - 628 EP - 33 JF - Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae JO - Zhongguo Yi Xue Ke Xue Yuan Xue Bao VL - 26 IS - 6 N2 - OBJECTIVE: To investigate the effects of standard meal and fat meal distending the fundus on transient lower esophageal sphincter relaxation (TLESR) and esophageal motility and to explore the mechanism of gastroesophageal reflux (GER) in patients with gastroesophageal reflux disease (GERD). METHODS: Eight patients with GERD (3 male, 5 female; median age: 43.5 ys) were enrolled in the study. All received 2 times of esophageal manometry and pH monitoring simultaneously for 30 min during fasting and 2 h after two different test-meals, including standard meal (SM) and fat meal (FM) on separate day at least 1 week apart. RESULTS: The frequency of TLESR significantly increased after 2 test-meals (P < 0.05). There were no significant difference in the frequency and duration of TLESR between SM group and FM group 1 h after meal (P > 0.05). However, the frequency of TLESR in FM group 2 h after meal was more than that in SM group and during fasting (P < 0.05). Lower esophageal sphincter pressure (LESP) significantly decreased in FM group than in SM group (P < 0.05). The contractive amplitude of post lower esophageal sphincter relaxation and the contractive amplitude of the distal esophagus had no difference after FM and SM. Acid reflux episodes and duration of pH < 4 were larger after FM than after SM (P < 0.05). A total of 50.2% of GER occurred during decreased LESP and 37.8% during TLESR after FM, while 61.7% of GER occurred during TLESR after SM. CONCLUSIONS: Both the SM and FM can increase the frequency of TLESR in patients with GERD. Decreased LESP and increased frequency of TLESR after FM are the major mechanism of GER, while reflux after SM may attribute to the increased frequency of TLESR. SN - 1000-503X UR - https://www.unboundmedicine.com/medline/citation/15663221/[Effects_of_two_test_meals_on_transient_lower_esophageal_sphincter_relaxation_in_patients_with_gastroesophageal_reflux_disease_and_mechanism_of_gastroesophageal_reflux]_ L2 - http://www.diseaseinfosearch.org/result/2996 DB - PRIME DP - Unbound Medicine ER -