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

The frequency of gastro-oesophageal reflux (GOR) in sheep anaesthetized with halothane was reduced by withholding food and water for 24 hours. The total reflux volume increased. The effect of body position on GOR was studied by inclining the operating table at angles to the horizontal and positioning the head up or down on sand bags. The operative positions investigated were: right and left lateral recumbency with head down, dorsal recumbency with head down and right lateral recumbency with head up. Least GOR occurred when the sheep was in right lateral recumbency with a head up tilt and the body inclined at 20 degrees from the horizontal. A cuffed oesophageal drainage tube increased the incidence of GOR but prevented the chances of the aspiration of rumen material.
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PMID:Gastro-oesophageal reflux in halothane anaesthetized sheep. The effects of feeding and positioning. 318 89

The evaluation of infantile vomiting is bound up with many unresolved questions and continually evolving imaging technologies. This article addresses three specific areas of interest: the use of newer low-osmolality, water-soluble contrast media in the infant's gastrointestinal tract; the ever-controversial subject of gastroesophageal reflux; and the burgeoning role of gastrointestinal ultrasonography.
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PMID:The vomiting infant: recent advances and unsettled issues in imaging. 327 30

Previous clinical and experimental reports have implicated placement of a Stamm gastrostomy (SG) as a cause of gastroesophageal reflux (GER) in children. This study evaluates this problem by measuring alterations in the lower esophageal sphincter pressure (LES) after SG with and without maintenance of the esophagogastric angle of Hiss. In 20 cats (2.8-3.2 kg) general anesthesia was induced using 20 mg/kg ketamine im. Esophageal manometrics were measured using a continuous perfusion catheter and recording system, evaluating three measurements for each animal. Eight cats (Group I) underwent SG placement in the anterior stomach wall two-thirds of the way down from the fundus. This was tacked to the anterior abdominal wall 3 cm lateral to the midline at the appropriate level. Six cats (Group II) had standard SG tube placement and in addition, two interrupted sutures were placed between the fundus and the esophagus maintaining the gastroesophageal angle of Hiss. Six cats (Group III) had sham laparotomy. After awakening, the animals were fed cat chow and water ad libitum. At 7 and 14 days, the animals were reanesthetized with ketamine and manometrics were repeated. Preoperative LES pressure measured 11.3 +/- 4.7 Torr. LES pressure in Group I decreased to 6.61 +/- 1.6 Torr at 7 days (P less than 0.01) and 4.8 +/- 1.6 Torr at 14 days postoperatively (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Changes in lower esophageal sphincter pressure (LES) after Stamm gastrostomy. 329 91

We studied the effect of esophageal acid perfusion on salivation in patients with reflux esophagitis and in normal subjects. Serial 10-min saliva collections were obtained by expectoration during perfusion of the esophagus with water, and then 0.1 N HCl (pH 1.2) for 50 min or 0.01 N HCl (pH 2.1) for 120 min. Within 1-5 min of beginning 0.1 N HCl perfusion, all 8 patients with esophagitis developed heartburn accompanied by an increase in saliva flow. By the time the severity of heartburn required discontinuation of HCl perfusion (10-40 min), saliva flow had increased nearly fourfold. With 0.1 N HCl perfusion, 8 of 10 volunteers developed mild heartburn after 22 +/- 3 min (mean +/- SE), whereas 0.01 N HCl induced heartburn in 6 of 10 volunteers after 57 +/- 12 min of perfusion. Saliva flow increased concurrently with the onset of heartburn and doubled in those volunteers who developed heartburn. Saliva flow did not change in those volunteers who were without heartburn. We conclude that esophageal acid perfusion unaccompanied by heartburn does not affect salivation. However, saliva flow increases concurrently with the onset of heartburn, a phenomenon called "water brash" when clinically evident. The increased saliva flow that accompanies heartburn may act as an endogenous antacid that serves as a protective response to symptomatic gastroesophageal reflux.
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PMID:Salivary response to esophageal acid in normal subjects and patients with reflux esophagitis. 367 54

The aim of this study was to compare gastroesophageal 99mTc scintiscanning (GES), the pH reflux test (TRA) and esophageal manometry in the assessment of gastroesophageal reflux (GER). GES was performed after oral intake of sulfur colloid labeled with 99m technetium and 300 ml of water. Calculation of an index of reflux gave a semi-quantitative assessment of the GER. Sixty patients with symptoms of GER (typical in 51 cases, atypical in 9 cases) had the three tests. A GES was also performed in 17 normal volunteers and in 12 patients of the series after fundoplication. The diagnostic specificity of GES was 1.0 in GER. GES was less frequently positive than the pH reflux test in GER (68.6 p. 100 versus 80.4 p. 100) but the difference was not significant. These two tests were more sensitive than manometry. The index of reflux was higher in patients than in control subjects (p less than 0.0005) and returned to normal values after fundoplication. A correlation between the index of reflux and the stage of pH-reflux test was observed. It is suggested that GES can be used in the initial assessment of GER as an alternative to TRA and performed repeatedly during the follow-up of patients treated surgically.
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PMID:[Gastroesophageal 99mTc scintigraphy in gastroesophageal reflux]. 369 86

A study was undertaken to determine whether reflux could be reduced or prevented by creation of a nipple valve at the distal end of a reversed gastric tube. The gastric tube was constructed in standard fashion in six adult dogs. The tube was placed through a substernal tunnel to a cutaneous ostomy in the neck. An antireflux valve was then created by invaginating the lower end of the tube into the gastric remnant. The following observations were made before and after creation of the valve: (1) gastric distending pressure required to produce efflux of saline from the ostomy; (2) manometric pressure at the stomach-tube junction; and (3) 2-hour pH monitoring within the tube after acid infusion into the stomach. The valve shortened the gastric tube by 2.0 to 2.5 cm. It did not obstruct antegrade flow of saline. Prior to creation of the valve, reflux of saline out of the cutaneous ostomy occurred at an average pressure of 62 cm H2O (range 25 to 80). The antireflux procedure prevented reflux with distending pressures up to 200 cm H2O. Manometry revealed an average pressure of 18 cm H2O (range 5 to 25) at the lower end of the tube before creation of the valve. The antireflux procedure raised this high pressure zone to 60 cm H2O (Range 50 to 65) (P less than 0.05). Spontaneous reflux was rarely observed in the anesthetized dog when acid was infused into the stomach and the pH was monitored in the gastric tube. Acid reflux could easily be produced by application of minimal manual pressure to the closed abdomen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An antireflux procedure for use with the reversed gastric tube. 372 8

Multiple factors contribute to the production of esophagitis in gastroesophageal reflux (GER), but the respective roles of esophageal (i. e. lower esophageal sphincter (LES) tone, peristalsis) and gastric factors (i. e. acid secretion and gastric emptying) are not well known. The aim of this work was to study the frequency and the severity of esophageal and gastric abnormalities observed in the same patients and to correlate these findings with the degree of esophagitis. Thirty-three consecutive patients with GER proven by esophageal pH recording (3-hr postprandial pH-test) were classified according to the presence (group A, n = 18) or absence (group B, n = 15) of severe esophagitis (i. e. erosions, ulcerations, or stenosis) at endoscopy. LES basal tone and esophageal peristalsis were studied by manometry. Gastric acid secretion and emptying of liquids were measured by intragastric titration coupled with the dye dilution technique. Results obtained in GER patients were compared with those found in twenty-three normal subjects. Hypotonia of LES (i. e. LES tone less than 7 cm H2O) was more frequent in group A (72 p. 100) than in group B patients (30 p. 100, p less than 0.05). Magnitude of esophageal peristaltic waves was lower in group A than in group B (p less than 0.10). When compared to values found in normal subjects, gastric emptying and acid secretion were not significantly different both in presence and in absence of esophagitis. There was no linear correlation between esophageal pH parameters and acid secretion values or gastric emptying rates.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Reflux esophagitis: respective roles of esophageal and gastric pathogenic factors]. 379 41

The combined Collis gastroplasty-Nissen fundoplication consists of a combination of an esophagus-lengthening Collis gastroplasty with 360 degrees complete Nissen fundoplication operation. This report reviews the clinical and radiographic features of 60 consecutive patients who underwent this operation for the control of symptomatic gastroesophageal reflux. The surgical procedure, the technique of postoperative radiographic examination, normal radiographic anatomy, and abnormalities detectable radiographically are briefly described. All patients were examined on the seventh postoperative day initially with iodinated water-soluble contrast medium followed by barium to establish integrity of the gastroplasty tube, fundoplication wrap, and dilated esophageal stricture. Later in the postoperative period, elective barium esophagrams were prompted by complaints of dysphagia (three patients) and symptoms of gastroesophageal reflux (five patients).
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PMID:The combined Collis gastroplasty-Nissen fundoplication: surgical procedure and radiographic evaluation. 387 91

Three infants presenting with respiratory distress required early ventilator support. With attempts at extubation recurrent airway obstruction occurred. The clinical course was marked by recurrent episodes of hyperinflation, atelectasis, and pneumonia. Bronchoscopy, bronchography, and chest fluoroscopy revealed extensive collapse of the trachea and main stem bronchi. Two of the infants had gastroesophageal reflux and recurrent aspiration. Treatment of tracheobronchomalacia (TBM) was carried out with a tracheostomy tube attached to a portable CPAP apparatus. Initially CPAP was maintained at 10 cm of water and subsequently weaning was achieved by gradual decreasing of both positive pressure and hours of treatment per day. Total treatment time ranged from 13 to 25 months. Feedings were carried out via gastrostomy. Two infants with severe gastroesophageal reflux underwent fundoplication. Each infant was successfully weaned from distending pressure and decanulated. The treatment of severe TBM with long-term CPAP appears to be a reasonable alternative or adjunct to surgical procedures such as tracheopexy, resection, external splinting and tracheobronchoplasty.
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PMID:Management of tracheobronchomalacia with continuous positive airway pressure. 390 98

Roentgenologic and manometric findings in diseases of the esophagus in infants and children were compared. With both procedures combined it was possible to determine the exact localization of the lower esophageal sphincter. For the demonstration of gastroesophageal reflux the roentgenologic water siphon test was used. The excellent correspondence of the results of the water siphon test with manometric findings demonstrated the reliability of this roentgenologic method for detection of reflux. In borderline cases simultaneous manometric and roentgenologic studies were also of great use for demonstration of hiatus hernia.
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PMID:Correlation between manometric and roentgenologic findings of diseases of the esophagus in infants and children. 392 19


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