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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifteen normal volunteers without symptoms of gastroesophageal reflux and sixteen patients with symptoms of gastroesophageal reflux unresponsive to medical management and having endoscopic esophagitis had esophageal manometry and twenty-four hour pH monitoring of the distal esophagus. The symptomatic patients underwent a Nissen antireflux procedure and were restudied at four months. After surgery, patients had less reflux, a higher sphincteric pressure, and an equal amount of sphincter within the abdomen as did asymptomatic control subjects.
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PMID:Evaluation of the Nissen antireflux procedure by esophageal manometry and twenty-four hour pH monitoring. 0 24

Twenty-four pH monitoring the distal esophagus quantitates gastroesophageal reflux in a near physiologic setting by measuring the frequency and duration of acid exposure to the esophageal mucosa. Fifteen asymptomatic volunteers were studies with 24-hour pH and esophageal manometry. The normal cardia was more competent supine than in the upright position. Physiologic reflux was unaffected by age, rarely occurred during slumber, and was the rule after alimentation. One hundred symptomatic pateitns with an abnormal 24-hour pH record (2 S.D. above the mean of controls) could be divided into three patterns of pathological reflux: those who refluxed only in the upright position (9), only in the supine position (37), and in both positions (54). Upright differed from supine refluxers by excessive aerophagia causing reflux episodes by repetitive belching. Compared to controls, they had excessive post-prandial reflux, lower DES pressure, and less DES exposed to the positive pressure of the abdomen. Supine differed from upright refluxers by having a higher incidence of esophagitis and an inability to clear the esophagus of acid after a supine reflux episode. Compared to controls, they had only a lower DES pressure. Combined refluxers had a higher incidence of esophagitis than supine refluxers. Stricture (15%) was seen only in this group. They were similar to supine refluxers in their inability to clear a supine reflux episode. Compared to controls, they had a lower DES pressure and less DES exposed to the positive pressure of the abdomen. Forty of the 100 patients had an antireflux procedure (4 upright, 8 supine, 28 combined). The most severe postoperative flatus and abdominal distention was seen in the upright refluxers. It is concluded that minimal reflux is physiological. Patients with pathological reflux all have lower DES pressure. Patients with upright reflux have less of their DES exposed to the positive pressure environment of the abdomen. Patients with supine reflux have an inability to clear the esophagus of reflux acid and are prone to develop esophagitis. Patients with both upright and supine reflux have the most severe disease and are at risk in developing strictures. In patients with only upright reflux, aerophagia and delayed gastric emptying may be an important etiological factor.
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PMID:Patterns of gastroesophageal reflux in health and disease. 1 47

Intraluminal pH in the lower esophagus has been recorded during a 3-hr period following a ligh meal and a consecutive 12-hr nocturnal period in 20 patients with typical symptoms and radiological evidence of gastroesophageal reflux and in 10 patients without such signs of reflux. Evidence of acid reflux was obtained in 3 of the patients without reflux during the postcibal period but in only one during the 12-hr nocturnal period. In contrast all except one of the 20 patients who had evidence of reflux showed spells of high acidity both in the postcibal and nocturnal periods. There was no clear correlation between the frequency of paf high acidity in the nocturnal period. Those patients with endoscopic evidence of severe esophagitis showed a significantly longer duration of high esophageal acidity in the nocturnal period. We conclude that nocturnal exposure of the esophageal mucosa to acid is a major factor in the causation of reflux esophagitis.
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PMID:Esophageal intraluminal pH recording in the assessment of gastroesophageal reflux and its consequences. 1 83

Lower esophageal pH was continuously monitored for 15 hours in 10 asymptomatic subjects and 27 patients with symptoms of gastroesophageal reflux, and the pH measurements in symptomatic patients were compared with the results of other esophageal investigations. Symptomatic patients had significantly longer periods of reflux in the pH test than asymptomatic subjects (P less than 0.01), but there was no significant correlation between the pH measurements and the results of esophageal manometry, acid-perfusion, and acid-clearing tests. Ten patients had evidence of esophagitis at esophagoscopy, but there was no correlation between pH measurements and the findings at esophagoscopy. Two patients with esophagitis had no evidence of reflux in the pH monitoring test. The results indicate that the pH-monitoring test has a useful role in the diagnosis of gastroesophageal reflux in patients who do not have endoscopic signs of esophagitis. However, negative pH tests do not exclude the diagnosis of symptomatic reflux, and it appears that the test has no value in assessing the severity of esophageal inflammation.
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PMID:Diagnosis of symptomatic gastroesophageal reflux by prolonged monitoring of lower esophageal pH. 2 24

The incidence of aspiration, the causative esophageal pathophysiology, and the results of surgical therapy were evaluated in 100 patients with abnormal gastroesophageal reflux documented by 24-hour esophageal pH monitoring. Based on historical evidence, 48 patients were suspected to be aspirators. Eight patients had documented episodes of aspiration (drop on esophagela pH, followed by acid taste in mouth and onset of cough or wheezing spell) during the monitoring period. Nine patients were considered to be potential aspirators because they presented oral acid regurgitation without development of pulmonary symptoms. In five patients a primary respiratory disorder (PRD) induced gastroesophageal reflux. The remaining 78 patients had abnormal reflux without aspiartion or regurgitation. Aspirators had a 75% incidence of esophageal motor abnormality on manometry, and the clearance of refluxed acid was significantly delayed in the supine position. A history of heartburn and endoscopic evidence of esophagitis were present in only half of the patients who were documented aspirators. Potential aspirators were spared from aspiration by rapid esophageal clearance of refluxed acid unaffected by changes in body position. Patients with a PRD had higher distal esophageal segment (DES) pressure and normal esophageal motility with minimal esophagitis. Nonaspirators significantly improved their clearance while in the supine position, emphasizing the protective effect of esophageal peristalsis against aspiration. An antireflux procedure in five aspirators raised the DES pressure significantly and returned the reflux status to normal by 24-hour pH-monitoring standards. The incidence of aspiration appears to be less than that suspected by history and is due to a motor disorder that interferes with the ability of the esophagus to clear reflex acid. Abnormal pulmonary symptoms can induce or result from gastroesophageal reflux and, when the latter occurs, an antireflex procedure stops both reflux and aspiration.
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PMID:Gastroesophageal reflux and pulmonary aspiration: incidence, functional abnormality, and results of surgical therapy. 3 77

A preliminary communication on the excellent results of a new intraluminal prosthesis for palliative intubation of advanced oesophageal of cardial carcinoma is reported. Such prothesis includes an original and effective device to avoid gastro-oesophageal reflux and the ensuing peptic oesophagitis. Piloroplasty is considered convenient as an adjuvant in the prevention of gastro-oesophageal reflux.
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PMID:[Intubation of neoplastic esophageal stenoses. A new prosthesis with an antireflux device]. 5 13

Twenty-seven patients with symptomatic gastro-oesophageal reflux received cimetidine 1.6 g daily for 6 weeks and matching placebo for 6 weeks in a randomised double-blind crossover trial. They complained of significantly more episodes of pain on placebo than on cimetidine (1186 vs 581) and consumed significantly more antacid tablets on placebo than on cimetidine (1645 vs. 1011). Cimetidine and placebo had similar effects on mucosal sensitivity to acid and on oesophagitis assessed endoscopically and histologically, suggesting that the symptomatic benefit is the result of a simple antacid effect.
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PMID:Effect of cimetidine in symptomatic gastro-oesophageal reflux. 8 86

Of 136 institutionalized severely retarded children, 20 (15%) had recurrent vomiting. Of these 20, 15 had gastroesophageal reflux diagnosed by x-ray examination, acid reflux text, or both. Esophagitis was noted by endoscopy in ten of 14 patients with GER. Four patients were anemic and six had had one or more episodes of aspiration pneumonia in the 12 months prior to study. Reduced basal lower esophageal sphincter pressure was the most common manometric abnormality noted in the patients with GER. Responses of the LES to bethanechol and swallow were normal, as was the basal pressure of the upper esophageal sphincter. Abnormal propagation of esophageal peristalsis was seen in six patients, all of whom had moderate or severe esophagitis. When compared to the nonvomiting retarded patients, the GER patients had significantly lower mental age and higher incidence of scoliosis. Patients with GER who had basal LES pressure less than 10 mm Hg did not improve with medical management. Recurrent vomiting is a common and serious problem in severely retarded children, the organic cause of which can be demonstrated by the application of appropriate investigative techniques.
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PMID:Gastroesophageal reflux among severely retarded children. 15 51

A new pH capsule telemetry technique was used to measure the pH fluxes in the upper part of the gastrointestinal tract in normal volunteers, symptomatic patients and in those with hiatal herniorrhaphy during the preoperative and postoperative period. The Darvon-sized pH capsule is swallowed with ease and with minimal discomfort by a fasting patient. The pH of the surrounding media activates an FM radio transmitter within the capsule to emit a continuous radio signal which is converted by a receiver to a linear graph on a strip chart recorder. This pH capsule telemetry test is easy to perform on an ambulatory basis and allows an accurate and reproducible determination of the presence or absence of esophageal reflux in patients with and without a hiatal hernia. Its correlation with symptomatic reflux is higher than that found with a conventional gastrointestinal series examination. The technique allows a much clearer distinction to be made between those patients with real symptomatic esophagitis secondary to actual reflux and those with other esophageal, cardiac or pulmonary symptoms existing withour reflux. This study also reveals a consistently lower fasting gastric pH in patients with signs and symptoms of reflux than in normal individuals without reflux. The technique enabled a more accurate assessment of the efficacy of hiatal hernia repair and revealed a reduced degree of esophageal reflux in those patients who had undergone successful repair with fundic plication.
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PMID:A new hyrogen ion telemetry technique for evaluating gastroesophageal reflux. 23 91

Neither gastroesophageal reflux nor esophagitis were found to have a clear-cut relationship with gastric secretory output. Patients with esophagitis had significantly longer periods of reflux than those without esophagitis. It is concluded that the important factor in the genesis of esophagitis is the duration of contact between the esophageal mucosa with gastric contents rather than gastric secretory output.
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PMID:Gastric secretion, gastroesophageal reflux and esophagitis. 24 13


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