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Gastric fullness, physical activity, and proximal extent of gastroesophageal reflux.

Abstract

OBJECTIVES

Proximal extent of gastroesophageal reflux (PER) is relevant for symptoms in GERD patients. It has been suggested that PER is determined by the volume of the refluxate that, in turn, might depend on the degree of gastric fullness. Abdominal straining, during ambulation, increases the likelihood of gastroesophageal reflux. We assessed the influence of gastric fullness and ambulation on proximal extent of reflux.

METHODS

PER was assessed in 37 patients with GERD undergoing ambulatory pH impedance monitoring. In 14 controls and 19 GERD patients, esophageal pH impedance and gastric emptying were also studied simultaneously in stationary conditions. We compared PER during fasting, early postprandial (before half emptying), and late postprandial periods in ambulatory and stationary conditions.

RESULTS

More reflux episodes reached the proximal esophagus in the postprandial period compared to fasting (60%+/-4 vs 29%+/-3, p<0.05). In stationary conditions, early postprandial reflux reached higher proximal extent than late postprandial reflux (15+/-3% vs 8+/-4%, p<0.05). The proportion of reflux events reaching the proximal esophagus was significantly higher in ambulatory than in stationary conditions (29+/-5% vs 15+/-3%, p<0.05).

CONCLUSION

Compared to fasting, reflux episodes occurring after the meals are more likely to reach higher proximal extent, particularly so during the early postprandial period. The highest proportion of postprandial proximal reflux occurred in ambulatory condition. These findings suggest that reducing meal volumes and early postprandial physical activity might contribute to decrease proximal extent of reflux and postprandial GERD symptoms.

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  • Authors+Show Affiliations

    ,

    Centre for Gastroenterological Research, Catholic University of Leuven, Belgium.

    , , , , ,

    Source

    MeSH

    Adult
    Aged
    Circadian Rhythm
    Eating
    Electric Impedance
    Fasting
    Female
    Follow-Up Studies
    Gastric Emptying
    Gastric Juice
    Gastroesophageal Reflux
    Humans
    Hydrogen-Ion Concentration
    Inpatients
    Magnetic Resonance Imaging
    Male
    Middle Aged
    Motor Activity
    Outpatients
    Postprandial Period
    Stomach

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15929753

    Citation

    Emerenziani, Sara, et al. "Gastric Fullness, Physical Activity, and Proximal Extent of Gastroesophageal Reflux." The American Journal of Gastroenterology, vol. 100, no. 6, 2005, pp. 1251-6.
    Emerenziani S, Zhang X, Blondeau K, et al. Gastric fullness, physical activity, and proximal extent of gastroesophageal reflux. Am J Gastroenterol. 2005;100(6):1251-6.
    Emerenziani, S., Zhang, X., Blondeau, K., Silny, J., Tack, J., Janssens, J., & Sifrim, D. (2005). Gastric fullness, physical activity, and proximal extent of gastroesophageal reflux. The American Journal of Gastroenterology, 100(6), pp. 1251-6.
    Emerenziani S, et al. Gastric Fullness, Physical Activity, and Proximal Extent of Gastroesophageal Reflux. Am J Gastroenterol. 2005;100(6):1251-6. PubMed PMID: 15929753.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gastric fullness, physical activity, and proximal extent of gastroesophageal reflux. AU - Emerenziani,Sara, AU - Zhang,Xin, AU - Blondeau,Kathleen, AU - Silny,Jiri, AU - Tack,Jan, AU - Janssens,Jozef, AU - Sifrim,Daniel, PY - 2005/6/3/pubmed PY - 2005/8/10/medline PY - 2005/6/3/entrez SP - 1251 EP - 6 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 100 IS - 6 N2 - OBJECTIVES: Proximal extent of gastroesophageal reflux (PER) is relevant for symptoms in GERD patients. It has been suggested that PER is determined by the volume of the refluxate that, in turn, might depend on the degree of gastric fullness. Abdominal straining, during ambulation, increases the likelihood of gastroesophageal reflux. We assessed the influence of gastric fullness and ambulation on proximal extent of reflux. METHODS: PER was assessed in 37 patients with GERD undergoing ambulatory pH impedance monitoring. In 14 controls and 19 GERD patients, esophageal pH impedance and gastric emptying were also studied simultaneously in stationary conditions. We compared PER during fasting, early postprandial (before half emptying), and late postprandial periods in ambulatory and stationary conditions. RESULTS: More reflux episodes reached the proximal esophagus in the postprandial period compared to fasting (60%+/-4 vs 29%+/-3, p<0.05). In stationary conditions, early postprandial reflux reached higher proximal extent than late postprandial reflux (15+/-3% vs 8+/-4%, p<0.05). The proportion of reflux events reaching the proximal esophagus was significantly higher in ambulatory than in stationary conditions (29+/-5% vs 15+/-3%, p<0.05). CONCLUSION: Compared to fasting, reflux episodes occurring after the meals are more likely to reach higher proximal extent, particularly so during the early postprandial period. The highest proportion of postprandial proximal reflux occurred in ambulatory condition. These findings suggest that reducing meal volumes and early postprandial physical activity might contribute to decrease proximal extent of reflux and postprandial GERD symptoms. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/15929753/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=15929753 DB - PRIME DP - Unbound Medicine ER -