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

Glucose metabolism was studied in ewes fed 800 g chopped alfalfa hay (H) or 400 g alfalfa hay and 400 g corn grain given in whole (HWC), ground (HGC) or extruded (HEC) form. Daily intake of metabolisable energy and crude protein were: 5.8 MJ, 109 g; 9.0 MJ, 84 g; 9.5 MJ, 84 g and 8.5 MJ, 88 g in H, HWC, HGC and HEC, respectively. In situ ruminal degradability ranked whole, ground, and extruded corn in ascending order. Ruminal pH and concentration of acetic acid were lower and of propionic acid higher (P less than 0.05) in HEC than in HGC and HWC groups. Plasma level of glucose (P less than 0.10), insulin (P less than 0.05), and the ratio of insulin to non-esterified fatty acids (NEFA) (P less than 0.01) were higher in HEC than in other groups. Glucose irreversible loss (GILR) and entry rate (GER), recycling (GRec) and reentry (GRee) were determined by double isotope dilution procedure. GER, but not GILR, was higher in HWC than in H and HGC (6.98 mg/min/kg BW0.75 vs 3.97 and 4.24 mg/min/kg BW0.75, respectively; P less than 0.05) and than in HEC (4.84 mg/min/kg BW0.75; P less than 0.10). GRec and GRee were higher in HWC than in the other treatments. Grinding or extruding the grain increased ruminal degradability and decreased glucose entry rate.
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PMID:The influence of processing corn grain on glucose metabolism in ewes. 144 7

In children with chronic renal failure (CRF) anorexia, nausea, and vomiting are common yet poorly understood symptoms. We studied oesophageal and gastric motor function in 12 children (age 7 months-6.8 years) with severe CRF not undergoing dialysis who had persistent anorexia and vomiting. Eight of 12 patients had significant gastro-oesophageal reflux (reflux index 5.2% to 21.9%, mean 11.3%; controls < 5%), 7/10 had altered gastric half emptying times (T1/2) for 5% glucose or milk (glucose meal--controls: 8-14 min, two CRF patients: 18-25 min; milk meal--controls: 48-72 min, five CRF patients 27, 28, 82, 83, and 110 min). Gastric antral electrical control activity was abnormal in 6/11 patients, with different types of gastric dysrhythmias whereas the remainder and controls showed a regular dominant frequency of 0.05 Hz. In 7/9 patients fasting serum gastrin concentration was raised (53 to > 400, mean 168 pmol/l, controls < 40 pmol/l). All CRF patients with anorexia and vomiting had one or more disorder of foregut motility. The nature and variety of the motor disorders and the raised concentrations of circulating gastrin suggest that the normal environment generated by CRF affects the function of the smooth muscle of the foregut.
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PMID:Foregut motor function in chronic renal failure. 147 84

Results obtained in 120 patients with gastric carcinoma, and submitted between 1982 and 1989, to a total gastrectomy and a new technique of reconstruction with jejunum, are analyzed retrospectively. This technique associates, a jejunoplication around the terminal esophagus with the purpose to eliminate the entero-esophageal reflux and the risk of dehiscence, and a double jejuno-jejunostomy with the target to delay the emptying of foods and to increase the reservoir function of the neo-stomach. In 63 of these patients a lymphadenectomy type R2-R3 has been held and in the remainder a type R1 lymph node dissection. Pre-operative chemotherapy was done when there was significant weight loss or proved obstruction of the cardia or pylorus by a radioisotopic method. Post-operative chemotherapy was continued immediately after operation in all the patients with pre-operative improvement. Operative mortality until the 60th day of Hospital stay was 5.8% and was mainly related with the advanced age of the patients and the spread and localization of the tumor. Operative morbidity was also more marked in tumors spreading to the cardia. The five years actuarial survival rate was 17.2% to the stage III and IV and 38.8% to the stage I and II. The quality of life of the patients has been favored by the kind of gastric reconstruction that has been used: Jejunoplication reduce the entero-esophageal reflux to nearly 20% and the double enterostomy, specially if the duodenal transit is maintained, induce a more slow post-operative emptying than other kinds of reconstruction. This fact is related with a more physiologic absorption of glucose and to a more favorable nutritional condition.
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PMID:[Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients]. 227 12

In a group of 19 infants being evaluated for gastro-esophageal reflux, we investigated the effects of various carbohydrate solutions (glucose polymers, 5% dextrose in water, and 10% dextrose in water) on the rate of postcibal gastroesophageal reflux during the first 2 h after a test feeding. The high-osmolality feeding (10% dextrose in water) produced significantly more postcibal gastroesophageal reflux over the entire 2-h interval. The major difference occurred in the second postcibal hour when the amount of gastroesophageal reflux was persistently high for 10% dextrose in water in contrast to the other feedings. We speculate that more rapid gastric emptying of low-osmolality solutions may account for these differences. Clear liquid feeding composition should be standardized during pH testing. Low-osmolality glucose polymer solutions may be more easily tolerated by infants with gastro-esophageal reflux who require carbohydrate or fluid supplements.
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PMID:Dietary caloric density and osmolality influence gastroesophageal reflux in infants. 275 22

Two cases of infantile dumping syndrome which developed following Nissen fundoplication for gastroesophageal reflux are described. Both infants were fed postoperatively via a gastrostomy and showed the typical clinical picture of dumping with failure to thrive, intermittent diarrhea, lethargy and pallor postprandially. Several glucose tolerance tests were highly pathological with marked hyperglycemia immediately after a gastrostomy meal followed by hypoglycemia two hours later. In one case HbA1c was significantly elevated which is thought to be an expression of recurrent hyperglycemia. In both infants the first and most impressive clinical sign was absolute refusal or oral feeds. Normal oral food intake was slowly re-established after normalization of blood glucose homeostasis.
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PMID:Dumping syndrome following Nissen's fundoplication: a cause for refusal to feed. 642 40

Fifteen patients with the combination of bronchial asthma and symptoms of gastro-esophageal reflux reproduced at endo-oesophageal acid perfusion (group 1) were investigated to detect bronchial obstruction, reflexly elicited from the distal oesophagus. Five patients with bronchial asthma but without symptoms of gastro-oesophageal reflux (group 2) and five patients with symptoms of gastro-oesophageal reflux but without respiratory symptoms (group 3) served as controls. The vital capacity (VC), the slope of the alveolar plateau (delta N2) and the closing volume (CV) were measured with the single breath nitrogen test before and after acid perfusion of the oesophagus, and again after antacid and glucose perfusion of the oesophagus. In group 1 a significant decrease of VC by 0.21 (P less than 0.001) and a significant increase of delta N2 by 0.9% (P less than 0.05) was seen while no change in CV was found. There was no change after acid perfusion in groups 2 or 3. After glucose and antacid the VC increased significantly in group 1 while no significant change was seen in delta N2 or CV. These findings were taken as indirect evidence of bronchial obstruction induced by the acid infusion. Since the changes were provoked in the sitting position and only in asthmatics with a positive acid perfusion test and since no patient complained of acid taste in the mouth it is unlikely that the bronchial obstruction was due to aspiration. A neural oesophago-bronchial reflex mechanism is suggested.
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PMID:Bronchial obstruction after oesophageal acid perfusion in asthmatics. 719 88

Liquid esophageal transit and gastric emptying, mouth-to-cecum transit, and whole gut transit of a solid-liquid meal were measured in 14 patients with PSS, 16 control subjects (esophageal transit), and 20 control subjects (gastrointestinal transit), respectively, by using scintigraphic techniques, the hydrogen breath test, and stool markers. In patients with PSS, the glucose hydrogen breath test for detection of small intestinal overgrowth was performed and various gastrointestinal symptoms were determined. Esophageal transit and gastric emptying were significantly prolonged in PSS patients with 11 of 14 PSS patients (79%) disclosing delayed esophageal transit and eight of 14 PSS patients (57%) disclosing delayed gastric emptying. All PSS patients with prolonged gastric emptying also had delayed esophageal transit and there was a significant positive correlation between esophageal transit and gastric emptying (r = 0.696, P < 0.01). No significant differences between PSS patients and controls were detected concerning mouth-to-cecum transit and whole gut transit, but abnormally delayed mouth-to-cecum transit was found in four of 10 PSS patients (40%) and abnormally prolonged whole gut transit was detected in three of 13 PSS patients (23%). Small bacterial overgrowth was diagnosed in three of 14 PSS patients (21%). Delayed esophageal transit and gastric emptying were associated with dysphagia, retrosternal pain, and epigastric fullness, while prolonged whole gut transit was associated with constipation. It is concluded that delayed gastric emptying is frequently associated with esophageal transit disorders in PSS patients and may be one important factor for the development of gastroesophageal reflux disease in these patients.
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PMID:Gastrointestinal transit through esophagus, stomach, small and large intestine in patients with progressive systemic sclerosis. 792 44

In children with vomiting, dyspepsia, and feeding problems, gastroesophageal reflux (GOR) and altered gastric emptying are common. We have used electrical impedance tomography (EIT) to study children with suspected gastric emptying disorders. Abnormalities of the gastric emptying curve suggestive of GOR were seen in some, with marked negative or positive shifts related to sharp increases or decreases in intragastric resistance. These findings could represent fluid leaving or entering the stomach, as might occur in GOR. To confirm the origin of the abnormal EIT curves, we devised and in vitro tank test system, and we performed simultaneous 2-h EIT and intraoesophageal pH monitoring after a glucose meal on six patients. In vitro, reflux of > or = 25 ml produced clearly detectable changes on the emptying curves. In vivo, the overall correlation between the times of 42 GOR episodes lasting > or = 1 min detected by pH study and the times of 38 negative peaks due to > or = 15% changes of the maximum intragastric resistivity detected by simultaneous EIT was significant; the correlation was highly significant in four of six patients. When the peaks were used to define GOR episodes on EIT gastric emptying curves, the two methods still showed good agreement. Retrospective examination of 50 patients who had undergone both EIT and 24-h intraoesophageal pH study during their diagnostic workup showed that EIT had a sensitivity of 94.6% and a specificity of 76.9% (with positive and negative predictive values of 0.92 and 0.83, respectively) for the detection of pathological GOR.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Detection of gastroesophageal reflux by electrical impedance tomography. 801 69

The effects of graded exercise on esophageal motility and gastroesophageal reflux were evaluated in nine nontrained subjects, using a catheter with three strain-gauge transducers connected to a solid-state datalogger and an ambulatory intraesophageal pH monitor. Subjects exercised on a stationary bike at 45%, 60%, 75%, and 90% of peak O2 uptake (VO2 max). Durations of exercise sessions and rest periods varied among subjects. Studies were performed after an overnight fast and subjects received only intravenous infusion of 5% glucose solution during the study. Plasma concentrations of gastrin, motilin, glucagon, pancreatic polypeptide (PP), and vasoactive intestinal peptide (VIP) were determined at rest and before and after each exercise session. The duration, amplitude, and frequency of esophageal contractions declined with increasing exercise intensity, and the differences were significant (P < or = 0.05) for all three variables at 90% VO2 max. The number of gastroesophageal reflux episodes and the duration of esophageal acid exposure were significantly (P < or = 0.05) increased during exercise at 90% VO2 max. Plasma regulatory peptide concentrations showed no significant changes between rest and the various exercise sessions. Thus, exercise has profound effects on esophageal contractions and gastroesophageal reflux, which are intensity dependent. These effects were not mediated by the hormones measured. The results were similar to those observed in highly trained athletes, suggesting that the effects of exercise on esophageal function are similar in trained and nontrained subjects performing at similar percentages of VO2 max, even though the absolute levels of exercise achieved in each group are different.
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PMID:Effect of graded exercise on esophageal motility and gastroesophageal reflux in nontrained subjects. 828 57

We evaluated the effect of graded exercise on esophageal motility and gastroesophageal reflux. We studied eight trained cyclists using a catheter with three strain-gauge transducers connected to a solid-state datalogger and an ambulatory intraesophageal pH monitor. Each study lasted 4 hr during which subjects exercised on a stationary bike for 1 hr at 60% of peak O2 uptake (O2 max), 45 min at 75% of O2 max, and for 10 min at 90% of O2 max. Subjects rested 1 hr before exercise (control period) and for 30 min between exercise sessions. Studies were performed after an overnight fast and subjects received only intravenous infusion of 5% glucose solution during the study. Plasma concentrations of gastrin, motilin, glucagon, pancreatic polypeptide (PP), and vasoactive intestinal peptide (VIP) were determined at rest and before and after each exercise session. The duration, amplitude, and frequency of esophageal contractions declined with increasing exercise intensity, and the differences were significant (P < or = 0.05) for all three variables at 90% O2 max. The number of gastroesophageal reflux episodes and the duration of esophageal acid exposure were significantly (P < or = 0.05) increased during exercise at 90% O2 max. Plasma hormone concentrations showed no significant changes between rest and the various exercise sessions. Thus, exercise has profound effects on esophageal contractions and gastroesophageal reflux which are intensity dependent. These effects are not mediated by the hormones measured.
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PMID:Effect of graded exercise on esophageal motility and gastroesophageal reflux in trained athletes. 842 34


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