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Relationship between acceleration of gastric emptying and oesophageal acid exposure in patients with endoscopy-negative gastro-oesophageal reflux disease.

Abstract

OBJECTIVE

A delay in gastric emptying has been reported in patients with gastro-oesophageal reflux disease (GORD), but its role in increasing the number of reflux episodes is still debated. The aim of this study was to assess the relationship between acceleration of gastric emptying and gastro-oesophageal reflux in patients with endoscopy-negative GORD and pathological oesophageal acid exposure.

MATERIAL AND METHODS

Twelve patients (7 M, age range 24-65 years) underwent 6-h postprandial (2.1 MJ meal) combined gastric emptying by real-time ultrasonography and intra-oesophageal pH monitoring after cisapride (20 mg b.i.d.) and placebo for 3 days, on two separate occasions at least 7 days apart in double-blind randomized order. Gastric emptying after placebo was also measured in 12 healthy volunteers (7 M, age range 25-54 years).

RESULTS

In the patients' group, the area under the emptying time curve was greater (p<0.01), and half and total emptying times prolonged (p<0.01) compared to the healthy subjects, 115 min (mean)+/-6 (SEM) versus 86+/-6 and 232 min+/-16 versus 160+/-7, respectively. Cisapride accelerated both half- and total gastric emptying (p<0.02): -22 min (mean); -10 to -34 (95% CI) and -48 min; -10 to -85, respectively, decreased both percentage of time at pH < 4 (p<0.01) and number of reflux episodes (p<0.05). However, no relationship was found between changes in gastric emptying and in the reflux variables by linear regression analysis (R2<0.005).

CONCLUSION

The emptying rate of the whole stomach is not a major determinant of gastro-oesophageal reflux.

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  • Authors+Show Affiliations

    ,

    Cattedra di Gastroenterologia, Dipartimento di Scienze Mediche, Università degli Studi di Milano, IRCCS Ospedale Maggiore, Via F. Sforza 35, IT-20122 Milan, Italy.

    , , ,

    Source

    MeSH

    Adult
    Aged
    Cisapride
    Double-Blind Method
    Endoscopy, Gastrointestinal
    Esophagus
    Female
    Gastric Acid
    Gastric Emptying
    Gastroesophageal Reflux
    Gastrointestinal Agents
    Humans
    Male
    Middle Aged

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    16785188

    Citation

    Carmagnola, Stefania, et al. "Relationship Between Acceleration of Gastric Emptying and Oesophageal Acid Exposure in Patients With Endoscopy-negative Gastro-oesophageal Reflux Disease." Scandinavian Journal of Gastroenterology, vol. 41, no. 7, 2006, pp. 767-72.
    Carmagnola S, Fraquelli M, Cantù P, et al. Relationship between acceleration of gastric emptying and oesophageal acid exposure in patients with endoscopy-negative gastro-oesophageal reflux disease. Scand J Gastroenterol. 2006;41(7):767-72.
    Carmagnola, S., Fraquelli, M., Cantù, P., Conte, D., & Penagini, R. (2006). Relationship between acceleration of gastric emptying and oesophageal acid exposure in patients with endoscopy-negative gastro-oesophageal reflux disease. Scandinavian Journal of Gastroenterology, 41(7), pp. 767-72.
    Carmagnola S, et al. Relationship Between Acceleration of Gastric Emptying and Oesophageal Acid Exposure in Patients With Endoscopy-negative Gastro-oesophageal Reflux Disease. Scand J Gastroenterol. 2006;41(7):767-72. PubMed PMID: 16785188.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Relationship between acceleration of gastric emptying and oesophageal acid exposure in patients with endoscopy-negative gastro-oesophageal reflux disease. AU - Carmagnola,Stefania, AU - Fraquelli,Mirella, AU - Cantù,Paolo, AU - Conte,Dario, AU - Penagini,Roberto, PY - 2006/6/21/pubmed PY - 2006/12/13/medline PY - 2006/6/21/entrez SP - 767 EP - 72 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 41 IS - 7 N2 - OBJECTIVE: A delay in gastric emptying has been reported in patients with gastro-oesophageal reflux disease (GORD), but its role in increasing the number of reflux episodes is still debated. The aim of this study was to assess the relationship between acceleration of gastric emptying and gastro-oesophageal reflux in patients with endoscopy-negative GORD and pathological oesophageal acid exposure. MATERIAL AND METHODS: Twelve patients (7 M, age range 24-65 years) underwent 6-h postprandial (2.1 MJ meal) combined gastric emptying by real-time ultrasonography and intra-oesophageal pH monitoring after cisapride (20 mg b.i.d.) and placebo for 3 days, on two separate occasions at least 7 days apart in double-blind randomized order. Gastric emptying after placebo was also measured in 12 healthy volunteers (7 M, age range 25-54 years). RESULTS: In the patients' group, the area under the emptying time curve was greater (p<0.01), and half and total emptying times prolonged (p<0.01) compared to the healthy subjects, 115 min (mean)+/-6 (SEM) versus 86+/-6 and 232 min+/-16 versus 160+/-7, respectively. Cisapride accelerated both half- and total gastric emptying (p<0.02): -22 min (mean); -10 to -34 (95% CI) and -48 min; -10 to -85, respectively, decreased both percentage of time at pH < 4 (p<0.01) and number of reflux episodes (p<0.05). However, no relationship was found between changes in gastric emptying and in the reflux variables by linear regression analysis (R2<0.005). CONCLUSION: The emptying rate of the whole stomach is not a major determinant of gastro-oesophageal reflux. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/16785188/Relationship_between_acceleration_of_gastric_emptying_and_oesophageal_acid_exposure_in_patients_with_endoscopy_negative_gastro_oesophageal_reflux_disease_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520500463449 DB - PRIME DP - Unbound Medicine ER -