Tags

Type your tag names separated by a space and hit enter

The role of transsphincteric pressure and proximal gastric volume in acid reflux before and after fundoplication.
Gastroenterology 2005; 129(6):1900-9G

Abstract

BACKGROUND & AIMS

This study was conducted to explore the role of proximal gastric volume and transsphincteric pressure on acid reflux during transient lower esophageal sphincter relaxation (TLESR) in patients with gastroesophageal reflux disease (GERD) both before and after laparoscopic fundoplication.

METHODS

Twenty GERD patients were studied before and after fundoplication along with 20 healthy controls. High-resolution manometry and pH recording was performed for 1 hour before and 2 hours following meal ingestion (500 mL/300 kcal). Three-dimensional ultrasonographic images of the stomach were acquired before and every 15 minutes after meal ingestion.

RESULTS

Postprandial proximal to total gastric volume distribution ratios were significantly larger in GERD patients before fundoplication (0.57 +/- 0.01; P < .05) and smaller following fundoplication (0.37 +/- 0.01; P < .001) compared with controls (0.46 +/- 0.01). The percentage of TLESRs associated with acid reflux did not relate to proximal gastric volume in any subject group. The transsphincteric pressure profile was different for TLESRs with and without reflux in GERD patients as well as in healthy controls. The pressure gradient across the esophagogastric junction (EGJ) (DeltaEGJp) was greater for TLESRs with acid reflux compared with TLESRs without acid reflux in both GERD patients (11.4 +/- 0.8 vs 8.0 +/- 0.5 mm Hg, respectively; P < .01) and controls (10.6 +/- 0.7 vs 7.1 +/- 0.8 mm Hg, respectively; P < .05). After fundoplication, DeltaEGJp during TLESRs was 7.9 +/- 0.9 mm Hg, and the transsphincteric pressure profile markedly changed.

CONCLUSIONS

Although proximal gastric volume plays a key role in eliciting TLESRs, it is not related to the incidence of acid reflux during TLESRs. The transsphincteric pressure gradient is greater in TLESRs associated with acid gastroesophageal reflux.

Authors+Show Affiliations

Gastrointestinal Research Unit, Department of Gastroenterology and Department of Surgery, University Medical Center, Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16344058

Citation

Scheffer, Robert C H., et al. "The Role of Transsphincteric Pressure and Proximal Gastric Volume in Acid Reflux Before and After Fundoplication." Gastroenterology, vol. 129, no. 6, 2005, pp. 1900-9.
Scheffer RC, Gooszen HG, Hebbard GS, et al. The role of transsphincteric pressure and proximal gastric volume in acid reflux before and after fundoplication. Gastroenterology. 2005;129(6):1900-9.
Scheffer, R. C., Gooszen, H. G., Hebbard, G. S., & Samsom, M. (2005). The role of transsphincteric pressure and proximal gastric volume in acid reflux before and after fundoplication. Gastroenterology, 129(6), pp. 1900-9.
Scheffer RC, et al. The Role of Transsphincteric Pressure and Proximal Gastric Volume in Acid Reflux Before and After Fundoplication. Gastroenterology. 2005;129(6):1900-9. PubMed PMID: 16344058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of transsphincteric pressure and proximal gastric volume in acid reflux before and after fundoplication. AU - Scheffer,Robert C H, AU - Gooszen,Hein G, AU - Hebbard,Geoff S, AU - Samsom,Melvin, PY - 2005/01/17/received PY - 2005/08/31/accepted PY - 2005/12/14/pubmed PY - 2006/2/4/medline PY - 2005/12/14/entrez SP - 1900 EP - 9 JF - Gastroenterology JO - Gastroenterology VL - 129 IS - 6 N2 - BACKGROUND & AIMS: This study was conducted to explore the role of proximal gastric volume and transsphincteric pressure on acid reflux during transient lower esophageal sphincter relaxation (TLESR) in patients with gastroesophageal reflux disease (GERD) both before and after laparoscopic fundoplication. METHODS: Twenty GERD patients were studied before and after fundoplication along with 20 healthy controls. High-resolution manometry and pH recording was performed for 1 hour before and 2 hours following meal ingestion (500 mL/300 kcal). Three-dimensional ultrasonographic images of the stomach were acquired before and every 15 minutes after meal ingestion. RESULTS: Postprandial proximal to total gastric volume distribution ratios were significantly larger in GERD patients before fundoplication (0.57 +/- 0.01; P < .05) and smaller following fundoplication (0.37 +/- 0.01; P < .001) compared with controls (0.46 +/- 0.01). The percentage of TLESRs associated with acid reflux did not relate to proximal gastric volume in any subject group. The transsphincteric pressure profile was different for TLESRs with and without reflux in GERD patients as well as in healthy controls. The pressure gradient across the esophagogastric junction (EGJ) (DeltaEGJp) was greater for TLESRs with acid reflux compared with TLESRs without acid reflux in both GERD patients (11.4 +/- 0.8 vs 8.0 +/- 0.5 mm Hg, respectively; P < .01) and controls (10.6 +/- 0.7 vs 7.1 +/- 0.8 mm Hg, respectively; P < .05). After fundoplication, DeltaEGJp during TLESRs was 7.9 +/- 0.9 mm Hg, and the transsphincteric pressure profile markedly changed. CONCLUSIONS: Although proximal gastric volume plays a key role in eliciting TLESRs, it is not related to the incidence of acid reflux during TLESRs. The transsphincteric pressure gradient is greater in TLESRs associated with acid gastroesophageal reflux. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/16344058/The_role_of_transsphincteric_pressure_and_proximal_gastric_volume_in_acid_reflux_before_and_after_fundoplication_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(05)01802-0 DB - PRIME DP - Unbound Medicine ER -