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Gastric distention: a mechanism for postprandial gastroesophageal reflux.

Abstract

The occurrence of gastroesophageal reflux after meals may be related to an increase in the rate of transient lower esophageal sphincter (LES) relaxations, the mechanisms of which are not understood. We investigated the effects of gastric distention on LES pressure in 16 normal subjects and 17 patients with gastroesophageal reflux disease. Intraluminal pressure was measured in the gastric fundus, LES, and esophageal body with a manometric catheter incorporating a sleeve device. Gastric distention was performed by injecting 0, 250, 500, or 750 ml of air in randomized order into a balloon and maintaining each stimulus for 15 min. Gastric distention did not significantly alter resting LES pressure in either group. During the basal period the rate of transient LES relaxation in the reflux patients (1.1 +/- 0.4 per 15 min) was greater than that in the normal subjects (0.6 +/- 0.1 per 15 min). Gastric distention resulted in a significant threefold to fourfold increase in the rate of transient LES relaxations in both groups. The reflux patients had a significantly greater proportion of complete relaxations (87%) than did the normal subjects (73%). We conclude that gastric distention, by significantly increasing the rate of transient LES relaxations in both normal subjects and patients with gastroesophageal reflux disease, may contribute to the postprandial increase in gastroesophageal reflux.

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  • Authors

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    Source

    Gastroenterology 89:4 1985 Oct pg 779-84

    MeSH

    Adult
    Eating
    Female
    Gastroesophageal Reflux
    Humans
    Male
    Manometry
    Middle Aged
    Muscle Relaxation
    Pressure
    Stomach

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    4029557

    Citation

    Holloway, R H., et al. "Gastric Distention: a Mechanism for Postprandial Gastroesophageal Reflux." Gastroenterology, vol. 89, no. 4, 1985, pp. 779-84.
    Holloway RH, Hongo M, Berger K, et al. Gastric distention: a mechanism for postprandial gastroesophageal reflux. Gastroenterology. 1985;89(4):779-84.
    Holloway, R. H., Hongo, M., Berger, K., & McCallum, R. W. (1985). Gastric distention: a mechanism for postprandial gastroesophageal reflux. Gastroenterology, 89(4), pp. 779-84.
    Holloway RH, et al. Gastric Distention: a Mechanism for Postprandial Gastroesophageal Reflux. Gastroenterology. 1985;89(4):779-84. PubMed PMID: 4029557.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gastric distention: a mechanism for postprandial gastroesophageal reflux. AU - Holloway,R H, AU - Hongo,M, AU - Berger,K, AU - McCallum,R W, PY - 1985/10/1/pubmed PY - 1985/10/1/medline PY - 1985/10/1/entrez SP - 779 EP - 84 JF - Gastroenterology JO - Gastroenterology VL - 89 IS - 4 N2 - The occurrence of gastroesophageal reflux after meals may be related to an increase in the rate of transient lower esophageal sphincter (LES) relaxations, the mechanisms of which are not understood. We investigated the effects of gastric distention on LES pressure in 16 normal subjects and 17 patients with gastroesophageal reflux disease. Intraluminal pressure was measured in the gastric fundus, LES, and esophageal body with a manometric catheter incorporating a sleeve device. Gastric distention was performed by injecting 0, 250, 500, or 750 ml of air in randomized order into a balloon and maintaining each stimulus for 15 min. Gastric distention did not significantly alter resting LES pressure in either group. During the basal period the rate of transient LES relaxation in the reflux patients (1.1 +/- 0.4 per 15 min) was greater than that in the normal subjects (0.6 +/- 0.1 per 15 min). Gastric distention resulted in a significant threefold to fourfold increase in the rate of transient LES relaxations in both groups. The reflux patients had a significantly greater proportion of complete relaxations (87%) than did the normal subjects (73%). We conclude that gastric distention, by significantly increasing the rate of transient LES relaxations in both normal subjects and patients with gastroesophageal reflux disease, may contribute to the postprandial increase in gastroesophageal reflux. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/4029557/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/0016-5085(85)90572-4 DB - PRIME DP - Unbound Medicine ER -