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)

We studied the effect of cisapride on oesophageal motor function and postprandial gastro-oesophageal reflux in a randomised, double blind, placebo controlled crossover study. In 16 patients with symptomatic gastro-oesophageal reflux, cisapride 10 mg orally and placebo were studied on separate days according to identical protocols. Cisapride and placebo were given 30 minutes before a standard meal. Each study day was preceded by corresponding three day oral loading of cisapride (10 mg tds) or placebo. Lower oesophageal sphincter pressure, oesophageal body motility and oesophageal pH were monitored for 30 minutes before and three hours after the meal. Plasma cisapride concentrations were measured before and after dosing on both study days. With cisapride treatment, the plasma cisapride levels ranged from 48.1 (5.0) to 75.9 (6.9) ng/ml. Plasma levels were undetectable during placebo treatment. Cisapride enhanced acid clearance but had no significant effect on the duration of acid exposure, the rate of reflux episodes, the pattern of lower oesophageal sphincter pressure associated with the reflux episodes, basal lower oesophageal sphincter pressure or oesophageal peristalsis. These findings do not suggest a major role for cisapride, at the dosage tested, for the control of troublesome postprandial gastro-oesophageal reflux.
Gut 1989 Sep
PMID:Effect of cisapride on postprandial gastro-oesophageal reflux. 268 Jul 94

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.
Gastroenterology 1989 Sep
PMID:Dietary caloric density and osmolality influence gastroesophageal reflux in infants. 275 22

Ambulatory esophageal pH monitoring, radiologic examination, endoscopy, and manometry were undertaken in 142 patients with globus. The results demonstrate that abnormal gastroesophageal reflux occurred in 23% of patients, implying that, while reflux may be responsible for globus in some patients, it is not the cause of globus sensation in the majority of individuals with this symptom. Comparing patients with globus and control subjects, there were no differences in lower esophageal sphincter pressures, esophageal body motility, or tonic upper esophageal sphincter pressures, but patients with globus exhibited higher pharyngeal and upper esophageal sphincter after-contraction pressures during deglutition. The physiological significance of this pharyngeal and upper esophageal dysmotility is not clear and it may be no more than a secondary phenomenon. Alternatively, it may contribute to the generation of globus, perhaps in combination with other physical and psychological triggers.
Arch Otolaryngol Head Neck Surg 1989 Sep
PMID:Pharyngoesophageal dysmotility in globus sensation. 276 26

Gastric acid secretion in response to a protein meal and to exogenously administered synthetic human gastrin 17-I was measured in patients with Barrett's esophagus, patients with uncomplicated gastroesophageal reflux, and normal age- and sex-matched controls. Acid secretion, both basally and in response to gastrin 17-I, was significantly greater in patients with Barrett's esophagus compared to normal individuals without reflux. Basal gastrin levels and meal-stimulated levels of the hormone were similar among all three groups. Sensitivity to gastrin, expressed as the concentration causing half-maximal acid secretion, was also similar among the study groups. It is speculated that elevated basal acid production in Barrett's esophagus may contribute to the pathogenesis of the disorder.
Dig Dis Sci 1989 Sep
PMID:Elevated gastric acid secretion in patients with Barrett's metaplastic epithelium. 276 98

We studied intraesophageal pressure changes in patients with symptoms of gastroesophageal reflux and an abnormal 24-hr pH monitoring record (N = 52). Our method was simultaneous esophageal manometry and pH monitoring. We observed a three-component esophageal manometric sequence (EMS). When this sequence recurred over and over, we termed this phenomenon "cycling." We found cycling in 35% of the patients (18/52). Those with cycling had lower basal LES pressures, more acid exposure, and an increased incidence of endoscopic esophagitis. That cycling resulted from repeated reflux events and their esophageal clearance was documented by scintigraphy during simultaneous manometry and pH monitoring (N = 7 patients). Cycling was found on the routine esophageal manometry record of 25% of symptomatic patients (N = 112) with an abnormal 24-hr pH score. In conclusion, cycling represents an esophageal manometric phenomenon due to repetitive reflux events. Its recognition during esophageal manometry may denote a severe reflux diathesis.
Dig Dis Sci 1989 Sep
PMID:Cycling, a manometric phenomenon due to repetitive episodes of gastroesophageal reflux and clearance. 276

Cigarette smoking is thought to adversely affect gastroesophageal reflux. Eight male patients with endoscopic evidence of gastroesophageal reflux had 24-h esophageal pH monitoring while smoking at least 20 cigarettes. This was repeated while abstaining from smoking the following day. In the initial study period, 28.3% of the reflux time occurred within 20 min of smoking a cigarette. There were fewer reflux episodes in the nonsmoking period (95.7 episodes vs 70.0). The patients had significant improvement while in the upright position (57 reflux episodes vs 28.5). Yet, total reflux time was not significantly changed (pH less than 4.0 11.2% of total time smoking vs 10.1% total time nonsmoking). Immediate cessation of smoking decreases the number of daily reflux episodes, but does not significantly affect total esophageal acid exposure in symptomatic patients with endoscopic evidence of gastro-esophageal reflux disease.
Am J Gastroenterol 1989 Sep
PMID:The immediate effects of cessation of cigarette smoking on gastroesophageal reflux. 277 2

1. A double-blind placebo controlled dose ranging study of the effect of single oral doses of 1 and 2 mg BRL 24924 and 10 mg metoclopramide on lower oesophageal sphincter pressure has been performed in 20 healthy volunteers. 2. The 2 mg dose of BRL 24924 caused a statistically significant increase in mean lower oesophageal sphincter pressure (P less than 0.05) at 30-45 min post-dose (20.8 +/- 7.1 cm H2O BRL 24924; 16.4 +/- 5.7 cm H2O placebo). BRL 24924 1 mg and metoclopramide 10 mg failed to increase lower oesophageal sphincter pressure at any time. However, eight volunteers with a hypotensive resting lower oesophageal sphincter pressure (less than 15 cm H2O) showed a statistically significant rise in pressure at 120 min for both 1 mg, 2 mg (P less than 0.01; P less than 0.001) BRL 24924 and 10 mg metoclopramide (P less than 0.01). No other significant effect was detected on oesophageal manometry. 3. BRL 24924 (2 mg) has statistically significant effects on lower oesophageal sphincter pressure. However, further studies in patients with gastro-oesophageal reflux disease and oesophagitis are needed to evaluate its clinical efficacy, especially where a hypotensive lower oesophageal sphincter pressure predominates.
Br J Clin Pharmacol 1989 Sep
PMID:A double-blind dose ranging study of BRL 24924 and metoclopramide on lower oesophageal sphincter pressure in healthy volunteers. 278 26

The advantage of a single-lumen end-hole catheter compared with the usual composite side-hole catheter for lower esophageal sphincter (LES) manometry has been studied in vitro and in vivo. In the present study LES pull-through manometry was performed with a special catheter, enabling simultaneous end-hole and side-hole recording of LES pressure. Eighteen normal individuals with normal 24-h pH-monitoring (control group) and 42 reflux patients with pathologic 24-h pH-monitoring (reflux group) were studied. End-hole recorded resting sphincter pressure (RSP) in the control group was 15.4 +/- 5.0 cm H2O and in the reflux group 6.4 +/- 6.4 (p less than 0.0005). Side-hole recorded RSP (mean S1-S3) was 20.8 +/- 11.6 and 11.9 +/- 6.8, respectively (p less than 0.005). End-hole recorded total sphincter length (SL) in the control group was 34 +/- 9 mm and in the reflux group 27 +/- 12 (p less than 0.025) and abdominal sphincter length (ASL) 23 +/- 7 and 16 +/- 9, respectively (p less than 0.005). Side-hole recorded SL was 30 +/- 7 and 30 +/- 12, respectively (NS) and ASL 22 +/- 6 and 18 +/- 9 respectively (NS). After intake of 500 ml of water both LES pressure and length decreased in both groups but the separation between the groups was neither improved nor impaired. The results support the view that LES insufficiency is an important cause of gastroesophageal reflux. That LES had a lower pressure and was shorter in patients with reflux was best demonstrated by end-hole recorded pressure.
Scand J Gastroenterol 1989 Sep
PMID:Lower esophageal sphincter pressure in normal individuals and patients with gastroesophageal reflux. A comparison between end-hole and side-hole recording techniques. 279 87

In a material of 25 patients with gastro-oesophageal reflux (GER), 11 had cerebral damage, 15 had symptoms of oesophagitis and 18 had respiratory problems including here six cases of apnoea with cyanosis and bradycardia resembling near-miss sudden infant death syndrome (SIDS). Only two of the children recovered acceptably on conservative treatment and the remainder were submitted to operation. Operation had insufficient effect in 30%. Cerebral damage or atresia of the oesophagus were present in all of the patients in whom operation was without effect. All children with symptom-producing GER should first be submitted to conservative treatment for at least three months and operation should be offered in cases where this treatment fails. Children with chronic or recurrent respiratory symptoms without other explanation and all children with episodes of apnoea and near-miss SIDS should be examined for the presence of GER.
Ugeskr Laeger 1989 Sep 11
PMID:[Gastroesophageal reflux in children. An overlooked disease]. 280 4

Dysphagia is a frequent cause of referral for oesophageal manometry although the motor response to eating is not routinely studied. We examined symptoms and oesophageal motor patterns in response to eating bread in 30 patients with either gastro-oesophageal reflux (n = 20), or normal oesophageal function tests (n = 10). No patient experienced symptoms while swallowing water but one complained of heartburn and one developed symptomatic oesophageal 'spasm' during eating. In eight further patients, pain or dysphagia which occurred with swallowing bread was associated with aperistalsis. Comparing asymptomatic and symptomatic periods, there was a slight increase in mean swallow frequency from 7.5 (0.79) (SEM) to 9.0 (1.17) swallows per minute (NS; n = 10). The mean number of aperistalsis swallows increased from 4.5 (0.96) per minute to 6.2 (1.30) (p less than 0.01; n = 10). Aperistalsis during symptoms was mainly caused by non-conducted swallows rather than synchronous contractions (mean 5.8 (1.45) per minute compared with 1.2 (0.44]. Aperistalsis can be produced by rapid swallowing in the normal oesophagus through 'deglutitive inhibition'. These results suggest that some patients experience dysphagia associated with aperistalsis perhaps as a response to increased frequency of swallowing. Functional abnormalities of this nature will not be detected by conventional oesophageal manometry.
Gut 1989 Sep
PMID:Oesophageal manometry during eating in the investigation of patients with chest pain or dysphagia. 280 85


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