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Relief of reflux symptoms after endoscopic gastroplication may be associated with reduced esophageal Acid sensitivity: a pilot study.
Endoscopy. 2005 Mar; 37(3):236-9.E

Abstract

BACKGROUND AND STUDY AIMS

Although the new endoscopic techniques for the treatment of gastroesophageal reflux disease (GERD) lead to marked clinical benefit, the underlying mechanism of this is unknown.

MATERIALS AND METHODS

In this prospective study, the effect of endoscopic gastroplication was investigated in six patients with GERD, who were assessed before and 4 weeks after treatment. The effect on reflux symptoms, quality of life, proton pump inhibitor (PPI) consumption, reflux esophagitis, acid exposure, esophageal motility, lower esophageal sphincter pressure (LESP), and gastric emptying was measured. Esophageal acid sensitivity before and after treatment was investigated using a standardized acid provocation test, and compared with that of six age- and sex-matched healthy controls.

RESULTS

Significant clinical benefit and discontinuation of PPI consumption after gastroplication was seen. Among the objectively measured parameters, only acid exposure was significantly reduced and gastric emptying significantly delayed. However, acid exposure remained pathologically high. Esophageal acid sensitivity was significantly reduced. The induction of heartburn and/or pain was abolished in four patients after gastroplication. In two patients the intensity of heartburn/pain was significantly reduced by 40 % or 60 %, and the time to provoke heartburn/pain significantly prolonged by 40% or 100%.

CONCLUSION

These preliminary data suggest that the decrease of esophageal sensitivity to acid after endoscopic gastroplication is part of the mechanism responsible for the reduction of reflux symptoms.

Authors+Show Affiliations

Department of Internal Medicine (Med. Klinik II), Klinikum Krefeld, Lutherplatz 40, 47805 Krefeld, Germany.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15731939

Citation

Wenzel, G, et al. "Relief of Reflux Symptoms After Endoscopic Gastroplication May Be Associated With Reduced Esophageal Acid Sensitivity: a Pilot Study." Endoscopy, vol. 37, no. 3, 2005, pp. 236-9.
Wenzel G, Kuhlbusch R, Heise J, et al. Relief of reflux symptoms after endoscopic gastroplication may be associated with reduced esophageal Acid sensitivity: a pilot study. Endoscopy. 2005;37(3):236-9.
Wenzel, G., Kuhlbusch, R., Heise, J., & Frieling, T. (2005). Relief of reflux symptoms after endoscopic gastroplication may be associated with reduced esophageal Acid sensitivity: a pilot study. Endoscopy, 37(3), 236-9.
Wenzel G, et al. Relief of Reflux Symptoms After Endoscopic Gastroplication May Be Associated With Reduced Esophageal Acid Sensitivity: a Pilot Study. Endoscopy. 2005;37(3):236-9. PubMed PMID: 15731939.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relief of reflux symptoms after endoscopic gastroplication may be associated with reduced esophageal Acid sensitivity: a pilot study. AU - Wenzel,G, AU - Kuhlbusch,R, AU - Heise,J, AU - Frieling,T, PY - 2005/2/26/pubmed PY - 2005/6/15/medline PY - 2005/2/26/entrez SP - 236 EP - 9 JF - Endoscopy JO - Endoscopy VL - 37 IS - 3 N2 - BACKGROUND AND STUDY AIMS: Although the new endoscopic techniques for the treatment of gastroesophageal reflux disease (GERD) lead to marked clinical benefit, the underlying mechanism of this is unknown. MATERIALS AND METHODS: In this prospective study, the effect of endoscopic gastroplication was investigated in six patients with GERD, who were assessed before and 4 weeks after treatment. The effect on reflux symptoms, quality of life, proton pump inhibitor (PPI) consumption, reflux esophagitis, acid exposure, esophageal motility, lower esophageal sphincter pressure (LESP), and gastric emptying was measured. Esophageal acid sensitivity before and after treatment was investigated using a standardized acid provocation test, and compared with that of six age- and sex-matched healthy controls. RESULTS: Significant clinical benefit and discontinuation of PPI consumption after gastroplication was seen. Among the objectively measured parameters, only acid exposure was significantly reduced and gastric emptying significantly delayed. However, acid exposure remained pathologically high. Esophageal acid sensitivity was significantly reduced. The induction of heartburn and/or pain was abolished in four patients after gastroplication. In two patients the intensity of heartburn/pain was significantly reduced by 40 % or 60 %, and the time to provoke heartburn/pain significantly prolonged by 40% or 100%. CONCLUSION: These preliminary data suggest that the decrease of esophageal sensitivity to acid after endoscopic gastroplication is part of the mechanism responsible for the reduction of reflux symptoms. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/15731939/Relief_of_reflux_symptoms_after_endoscopic_gastroplication_may_be_associated_with_reduced_esophageal_Acid_sensitivity:_a_pilot_study_ L2 - https://www.thieme-connect.com/DOI/DOI?10.1055/s-2005-860992 DB - PRIME DP - Unbound Medicine ER -