Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diurnal variations in the pattern of esophageal motility and acidity were studied in 14 healthy volunteers. Data from a two-channel manometry and one-channel pH-metry recording were stored in a portable 1-MByte, solid-state data logger for subsequent computerised analysis. Comparison of predefined nighttime, mealtime and nonmeal daytime periods showed that propagated contractions predominated during mealtimes (56% of all contractions) and nonmeal daytime periods (53.5% of contractions) and that their propagation velocity (2.98 cm/sec) was at its lowest and the AUC of all contractions (134.6 hectoPascal.sec) at its greatest during mealtime periods. During the night, propagated contractions (0.136/min) and simultaneous contractions (0.025/min) were significantly less frequent than during both meal (1.31/min and 0.172/min, respectively) and nonmeal daytimes (0.665/min and 0.133/min, respectively), whereas the nocturnal segmental contraction frequency (0.181/min) was not significantly lower than the nonmeal daytime contraction frequency (0.243/min). Median reflux time was in the normal range (1.2%), although two subjects had prolonged reflux times (9.5% and 14.5%). In conclusion, all subjects showed similar patterns of diurnal esophageal contractory activity determined partly by meal intake and partly by a characteristic clustering of nocturnal contractions that could not be explained by episodes of nocturnal gastroesophageal reflux. It may, therefore, be speculated that nocturnal contraction clusters are associated with rhythmic phenomena such as MMC or specific sleep stages.
 ...
PMID:Twenty-four-hour pattern of esophageal motility in asymptomatic volunteers. 220 86

Thirty to fifty percent of patients with reflux esophagitis fail to heal after treatment with conventional doses of H2-receptor antagonists, whereas omeprazole administration induces more than 90% healing. To investigate the effect of omeprazole and higher-than-presently-recommended doses of H2-blockers, we evaluated gastric acidity and gastroesophageal reflux in 17 patients with severe-moderate esophagitis before and after treatment with 300 mg ranitidine twice daily or 20 mg omeprazole once daily. Three pH-metric studies were performed, in a cross-over design, before and after 8 days of treatment with omeprazole or ranitidine. Both drugs significantly reduced intragastric acidity (p less than 0.001) during both night and day hours. Median hourly 24-h intragastric pH was 1.8 in the basal study, 2.9 after ranitidine, and 3.4 after omeprazole. Intragastric acidity fell from 84.0 mmol/L in the basal study to 14.2 mmol/L (79% inhibition) with ranitidine and 9.3 mmol/L (84% inhibition) with omeprazole. Patients with esophagitis were significantly more exposed to acid than healthy subjects, in both the supine and upright position (p less than 0.01). The time with esophageal pH less than 4 dropped from 23.9% in the basal study to 8.5% with ranitidine and to 7.2% with omeprazole (p less than 0.001). Both drugs significantly reduced esophageal exposure to acid in both the supine and upright positions (p less than 0.001), whereas neither had any effect on esophageal acid clearance.
 ...
PMID:Effect of omeprazole and high doses of ranitidine on gastric acidity and gastroesophageal reflux in patients with moderate-severe esophagitis. 203 11

Acidogenic function of the stomach and role of gastroesophageal reflux were assessed in relation to esophagitis genesis in 92 patients with portal hypertension and varicosity of the stomach and esophagus. Acidogenic function was found heterogenous. The relationship between gastric acidity, gastroesophageal reflux and esophagitis development seemed obscure, whereas that between esophageal varicosity of a definite degree and esophagitis was clear-cut.
 ...
PMID:[Pathogenesis of esophagitis in patients with portal hypertension]. 233 33

In order to evaluate whether combined esophageal and gastric pH-metry is feasible without interference due to the transcardial cable, four 24-hr ambulatory esophageal pH-metries were carried out in seven healthy volunteers in a randomized order. In two studies only one glass electrode was used. It was placed 5 cm above the lower esophageal sphincter. In the two other studies an additional electrode was placed in the corpus region 10 cm below the lower esophageal sphincter. In order to obtain a wide range of pH values, misoprostol (400 micrograms) was given at 9 AM and 9:15 PM in two studies. In the two other studies placebo was given. Misoprostol exerted only a weak and short-lasting effect on gastric acidity. The four measuring conditions did not differ with respect to medians of esophageal reflux time and duration of single reflux episodes, Kendall's coefficient of concordance yielded a high reproducibility for both variables (P less than 0.0025). Thus, combined esophageal and gastric pH-metry is feasible and highly reproducible.
 ...
PMID:Combined esophageal and gastric pH-metry in healthy volunteers. Influence of cable through LES and effect of misoprostol. 249 87

Twenty-four-hour gastric and esophageal pH were monitored simultaneously in 19 patients with moderate esophagitis before and after a randomized crossover treatment with 40 mg famotidine or 300 mg ranitidine. Gastroesophageal reflux in patients with esophagitis was compared with that in 22 healthy controls. Patients with esophagitis had more esophageal acidity than controls; the percentage of time with esophageal pH less than 4 was significantly greater during a 24-h period (p less than 0.01) both in the upright (p less than 0.01) and in the supine (p less than 0.01) position. In esophagitis patients the percentage of time with pH less than 4 during the total 24-h period correlated closely with acid reflux in the upright (p less than 0.001) and supine (p less than 0.01) position. This indicates that daytime reflux is probably as injurious to the esophagus as nighttime reflux. Famotidine and ranitidine decreased gastric acidity during the entire 24-h period (p less than 0.001) but not during the daytime or early evening. The inhibitory effect lasted slightly longer with famotidine (12 h) than with ranitidine (10 h). Famotidine and ranitidine reduced esophageal acidity during the entire 24-h period (p less than 0.001) and particularly during the nighttime (p less than 0.001) but not during the daytime. Famotidine and ranitidine also did not modify the esophageal acid clearance. Nightly doses of famotidine or ranitidine were ineffective in reducing GER during daytime hours.
 ...
PMID:Gastric and esophageal acidity during continuous treatment with H2-antagonists in uncomplicated esophagitis. 257 43

A series of 82 subjects affected with reflux esophagitis is presented. Gastroesophageal reflux and peptic esophagitis were discovered and staged by contrast meal and endoscopy with biopsy. All patients underwent medical therapy based on drugs affecting gastroesophageal motility and acidity of gastric content: this therapy was administered for three months, then was performed a control endoscopic examination. Endoscopic recovery of esophagitis allowed a long term maintenance therapy, endoscopically controlled every year. When esophagitis persisted, cycles of medical attack therapy, were repeated. surgical operation was performed in 15 cases in which either three cycles of medical therapy failed to improve esophageal lesions, or when endoscopy showed worsening esophagitis.
 ...
PMID:[Role of conservative therapy and surgical treatment in disease caused by gastroesophageal reflux]. 273 42

Twenty-four-hour continuous esophageal pH monitoring has become the preferred test to quantify acid gastroesophageal reflux. Agreement has been achieved that acid gastric content reflux into the esophagus constitutes a major cause of reflux esophagitis; we therefore calculated the "area under pH 4" (A) in 560 consecutive pH monitorings in infants 1-12 months old and related this parameter (A) to the reflux index (RI): RI less than 10%: A 185 +/- 295 (mean +/- 1 SD); RI 10-19%: A 1,046 +/- 1,206; RI 20-29%: A 1,967 +/- 2,038; RI 30-39%: A 3,307 +/- 2,955; RI greater than 40%: A 7,977 +/- 7,227. A higher RI is associated with a greater area under pH 4 (p less than 0.001); the high SD obtained in each group, however, illustrates the great variability in surface (or acidity of the reflux episodes) in all groups. Esophagoscopy and biopsy were performed in 112 infants (20%). Specificity in the prediction of (mild) esophagitis was higher for the area under pH 4 (88%) compared with the RI (50%). The sensitivity of both parameters was comparable (96 versus 93%). Our results strongly suggest that in young infants, the acidity of the reflux episodes (the area under pH 4) is a determining factor in the prediction of esophagitis. These data need to be confirmed by more studies before general application of this parameter can be advised.
 ...
PMID:Area under pH 4: advantages of a new parameter in the interpretation of esophageal pH monitoring data in infants. 277 67

We studied 76 patients with symptoms of heartburn, regurgitation, or both and 38 asymptomatic control subjects by measuring the gastric emptying of technetium-99m-labeled oatmeal. In addition, we performed 24-hour esophageal pH monitoring and manometric studies of the esophagus on all study participants. Endoscopy was performed on all patients. Patients with proved reflux on 24-hour pH monitoring, in comparison to those without reflux and the control subjects, had a shorter lower esophageal segment with a lower pressure and more esophagitis. Delayed gastric emptying occurred with equal frequency in patients with and without reflux. Esophageal reflux was not associated with delayed gastric emptying. Delayed emptying was associated with less esophagitis than found in those with normal gastric emptying, suggesting that the prolonged presence of food in the stomach may have a buffering effect on gastric acidity. We concluded that delayed emptying is not a major factor in the pathophysiology of gastro-esophageal reflux disease and that therapy aimed at speeding gastric emptying cannot be supported by our results.
 ...
PMID:Does delayed gastric emptying contribute to gastroesophageal reflux disease? 291 Jan 30

Twenty-two consecutive patients with gastroesophageal reflux and erosive or ulcerative esophagitis entered a double-blind, randomized study comparing the effect of 20 mg omeprazole once daily with that of 150 mg ranitidine twice daily on esophageal acidity. Ambulatory 24-h esophageal pH measurements were performed within 1 month before inclusion and after 3 weeks of medication. Omeprazole significantly (p less than 0.05) reduced the number of reflux (pH less than 4) episodes, the number of refluxes lasting greater than 5 min, and the total reflux time. In contrast, ranitidine significantly reduced only the total reflux time. When the two treatment groups were compared, a significant difference in favor of omeprazole was found for daytime and total reflux values, except for the longest reflux and the number of reflux episodes lasting greater than 5 min. Substantial differences, also in favor of omeprazole, were found with regard to the effect on endoscopic healing of the esophagitis.
 ...
PMID:The effect of omeprazole or ranitidine treatment on 24-hour esophageal acidity in patients with reflux esophagitis. 307 25

Gastro-oesophageal reflux (GOR) occurs mainly during postcibal (PC) periods. The duration of PC gastric acidity and the incidence of GOR were analysed in 11 asymptomatic premature infants. GOR was studied during PC periods of 120 min and also during the following 120 min defined as fasting (FT) periods. These infants were subjected to simultaneous continuous gastric and oesophageal pH monitoring using a double-blind crossover technique. Two formulae with different fat contents (2.6 vs 3.6 g/100 ml) and different carbohydrate concentrations (8.1 vs 7.3 g/100 ml; malto-dextrin 2.8 vs 1.9 g/100 ml) were given. Gastric acidity (pH less than 4) in the PC periods lasted significantly (P less than 0.001) longer (68 min +/- 10) with the low fat/high malto-dextrin formula versus 43 min +/- 11 with the high fat/low malto-dextrin formula. Oesophageal pH monitoring data were within normal limits for the total investigation time in all infants. During PC periods acid GOR was detected more frequently in the group with a low fat formula. More PC GOR was recorded when the gastric acidity time was longer.
 ...
PMID:Effects of formula feeding on gastric acidity time and oesophageal pH monitoring data. 323 38


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>