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

Values of intraesophageal pH, basal fundal pH and hydrochloric acid debit were studied in 73 patients with exacerbation of peptic ulcer on the first days of exacerbation and 2-4 weeks after the initiation of therapy with various drugs. Gastrozepin and cimetidine in parallel with gastric acidity inhibition reduced regularly and considerably a degree of gastroesophageal reflux in the patients. The action of combined vicalin and almagel therapy was manifested later on and was less marked.
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PMID:[The degree of gastroesophageal reflux during treatment of the exacerbation of duodenal peptic ulcer by various drugs]. 336 61

Association of age with gastroesophageal pH and motor parameters have been searched for previously, but most studies have been cross-sectional. The aim of the present investigation was to evaluate the influence of age on gastroesophageal sphincter pressure, acid clearing ability, and acid gastroesophageal reflux in the same group of normal subjects. Ten healthy subjects were investigated in the period May 4, 1977, to February 18, 1978, and reinvestigated in the period August 19, 1985, to January 29, 1986. The median interval between the two investigations was 8.0 yr, range 7.7-8.5 yr. There were eight men and two women, with a median age at the second investigation of 36 yr, range 30-53 yr. Measurement of gastroesophageal sphincter pressure (GESP) and an acid perfusion test were performed, and within the same week, an acid-clearing test and a prolonged monitoring of pH in the distal part of the esophagus were carried out (5 cm proximally to the GES). pH monitoring was initiated between 7 and 8 PM and terminated between 7 and 8 AM. There were no changes in GESP between the two investigations. All had a normal acid perfusion test in both investigations. No changes in acid-clearing ability could be demonstrated. Similarly, the number of reflux episodes, as well as the duration of acid reflux, were unchanged. Integration of the pH curve for pH values less than or equal to 4 gave similar results at both occasions. In addition, the relative time with pH values less than or equal to 4 was unchanged. The acidity of the potential reflux material did not change over time, as evaluated by intragastric pH before and after monitoring. In conclusion, this study did not demonstrate any influence of age on esophageal acid defense mechanisms or spontaneous gastroesophageal reflux.
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PMID:The influence of age on esophageal acid defense mechanisms and spontaneous acid gastroesophageal reflux. 337 18

Simultaneous monitoring of esophageal and gastric pH in infants makes clear some peculiarities of digestive physiology and improves the sensibility of the simple method, usual mean of diagnosis of GER. In that way, a gastro-esophageal pH gradient is showed; gradient absolutely necessary to a good interpretation of this test. In twenty-two infants, younger than one year, continuous and extended monitoring of esophageal and gastric pH was realised with a specially-designed-combination microelectrode. Results pointed out that, after a meal, especially a milked meal, the post prandial period isn't suitable for the diagnosis of GER. Indeed, the gastric acidity is buffered, sometimes during many hours: that decreases or cancels the gastro-esophageal pH gradient. Besides, transient neutralisation periods of gastric acidity may occur, perhaps related with duodenogastric-biliary reflux. Before two months, the gastric pH is less acid that involves, one more time, on insufficient gastro-esophageal pH gradient for the diagnosis of GER.
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PMID:[Value of simultaneous monitoring of esophageal and gastric pH in infants]. 372 6

Using prolonged esophageal pH monitoring, we examined 42 infants referred for gastroesophageal reflux (GER) over a 16-month interval. Eighteen of these infants were also examined with intragastric pH monitoring following a standard formula meal. We found that prematurity and postcibal gastric acidity were significantly correlated with the amount of GER observed. Historical symptoms appeared to have little correlation with the amount of GER as measured by prolonged intraesophageal pH monitoring.
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PMID:Effects of maturation and gastric acidity on gastroesophageal reflux in infants. 375 16

Gastroesophageal reflux was looked for in 51 children with chronic obstructive respiratory disease (CORD) using prolonged pH monitoring. An index of reflux aggressivity dependent on both duration and acidity of refluxed material was calculated. This index was significantly related to the macroscopic endoscopic findings, patients with an elevated acidity index having more severe "endoscopic esophagitis" than patients with a normal acidity index. We conclude that the finding of normal, erythematous or destructive esophagitis at endoscopy has at least some clinical relevance.
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PMID:Is the macroscopic aspect of the esophagus at endoscopy indicative of reflux esophagitis? 394 7

The study was designed to obtain information on selected extrapulmonary effects of enprofylline, an adenosine-non-blocking alkylxanthine that is about 5 times more potent as a bronchodilator than the adenosine receptor antagonist theophylline. Effects of theophylline (5.0 mg/kg) on lower esophageal sphincter pressure (LESP), gastric secretion, and diuresis and of enprofylline (1.5 mg/kg intravenously producing about 2 micrograms/ml plasma) were examined in 8 healthy volunteers. Enprofylline and theophylline decreased LESP (by 5.0 +/- 2.6 mm Hg, mean +/- SD, p less than 0.001, and by 5.8 +/- 2.7 mmHg, p less than 0.001, respectively), but only theophylline stimulated gastric secretion (volume p less than 0.01 and acidity p less than 0.01) and urine production (volume p less than 0.01 and sodium chloride excretion p less than 0.01). Neither xanthine affected plasma gastrin. Enprofylline and theophylline can be expected to have a similar ability to reduce the barrier to gastroesophageal reflux, but only the latter would have additional stimulant effects on gastric secretion and diuresis. These findings may have clinical significance and suggest a role for adenosine in regulating gastric secretion (and diuresis) but not LESP.
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PMID:Relaxation of lower esophageal sphincter and stimulation of gastric secretion and diuresis by antiasthmatic xanthines. Role of adenosine antagonism. 396 10

Based on a literature review and a personal series of cases treated, it is considered that gastroesophageal reflux results mainly from a mechanical process. The importance of the gastric musculature is emphasized, particularly the oblique fibers which form a thick belt encircling the esophagogastric function. Reflux is assumed to be almost exclusively due to loss of fixation of the point of attachment of this belt which, because of its particular texture, allows gastric dilatation to be propagated to the esophagogastric junction. The principal cause is the angular movement of the mobilized cardia. The same result is observed after iatrogenic destruction of this so-called muscular belt. Ulcerated reflux esophagitis is considered to be a serious disease comparable to duodenal ulcer, and the operative technique used aims both at reducing gastric acidity (vagotomy) and the construction of an anti-reflux assembly based on Hill's method. Results of the application of these principles in 61 consecutive cases are discussed.
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PMID:[Gastroesophageal reflux. Anatomical, physiological and surgical aspects. Apropos of 61 consecutive cases of peptic esophagitis surgically treated with the same procedure]. 665 5

Acid gastro-oesphageal reflux in normal human subjects is followed by oesphageal peristalsis. The aim of the present study was to investigate the influence of pH and volume during imitated reflux on oesophageal peristalsis. Fluid volumes of 2.5, 5, 10, and 15 ml (pH 1.0, 4.0, or 7.0) were instilled randomly in the lower end of the oesophagus in eight healthy subjects. Further, repeated instillations were carried out in one subject. Oesophageal pressures were measured 5, 10, and 15 cm oral to the gastro-oesophageal sphincter and in the pharynx, and pH 5 cm oral to the sphincter. Peristalsis confined to the oesophagus was found to be related to the volume of the instilled fluid, whereas pharynx-mediated peristalsis seemed to be related to the acidity of the fluid. It is concluded that peristalsis after imitated gastro-oesophageal reflux is influenced by both the volume and the acidity of the instilled fluid. Volume seems to initiate a local clearing mechanism, whereas low pH initiates pharynx-mediated peristalsis.
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PMID:Oesophageal peristalsis in normal subjects. Influence of pH and volume during imitated gastro-oesophageal reflux. 666 27

The effect of eating on childhood gastroesophageal reflux (GER) is unclear. Twenty-eight asymptomatic children and 28 children with symptoms of GER were fed apple juice or milk-formula and observed for 3 hr postcibal. Distal esophageal pH was monitored continuously during this interval and used to quantitate the frequency and duration of GER. A period of frequent GER occurred for up to 2 hr after apple juice feedings in asymptomatic children, whereas symptomatic patients had frequent GER for longer periods. Compared to apple juice feedings, milk-formula feedings resulted in a decreased esophageal acidity for the first 2 hr. However, the type of feeding did not affect GER seen in asymptomatic children more than 2 hr postcibal. The frequency and duration of postcibal GER were not reduced by the upright position in either group. Effective medical treatment of symptomatic children did not eliminate the frequent GER within 2 hr of apple juice feedings, whereas the Nissen fundoplication usually eliminated all GER. The absence of GER episodes following apple juice correlated with the inability of most children to burp or vomit following antireflux surgery. Therefore, frequent GER for up to 2 hr after clear liquid meals is probably physiologic in children. The effective control of vomiting by medical or surgical therapy correlated best with a decrease in GER more than 2 hr postcibal.
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PMID:Postcibal gastroesophageal reflux in children. 727 44

Gastroesophageal reflux of varying severity is a common disorder for which medical attention is sought at all levels, from pharmacists to specialist physicians and surgeons. This brief overview represents my current understanding of reflux, its effects on the esophagus and my personal approach to treatment of these disorders. Of necessity, because the literature is so extensive (a Medline search on reflux from 1966 to 1993 yielded over 1500 papers.), I have relied in places on the extensive review by Marks and Richter [1]. My paper emphasizes the evaluation and treatment of patients with symptomatic reflux, esophagitis and its complications. It describes why it is important to grade the disorders so that the treatment used is appropriate to the severity of the disease. The more severe the disease, the more specific the diagnostic information needed and the more exacting the treatment. Various treatments and outcomes of therapy are discussed, and a role for surgery is defined. The essence of effective medical treatment of esophagitis is to reduce acidity of the refluxate to a level outside the optimum proteolytic pH range of pepsin, i.e. greater than pH 3.5.
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PMID:Medical management of esophageal reflux. 750 31


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