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

Gastric emptying, gastric secretion and esophageal pH were studied prospectively in 32 patients who had either a Lortat-Jacob type operation (n = 7) or a fundoplication with a 360 degrees (n = 4), 270 degrees (n = 5) or 180 degrees (n = 16) gastric fundic wrap. The goal was to determine the effects of various antireflux mechanisms on these functions as well as to try to explain abnormal postoperative esophageal pH scoring indexes. Esophageal pH was recorded during the 3 h period following a standard meal. Acid reflux was expressed using a scoring index taking into account the duration and magnitude of pH fall. Preoperatively, all patients had an abnormal pH scoring index. Postoperatively, the pH scoring index remained increased in 7 patients (group A) and returned to normal values in 25 (group B). Clinical data, esophageal pH parameters and gastric acid secretion measured preoperatively were not significantly different in the two groups of patients. Preoperative gastric emptying for liquids was shorter in group A than in group B patients (p less than 0.05). Postoperative gastric emptying of radiopaque markers was not different in the two groups of patients. Postoperative resting pressure of the lower esophageal sphincter was always less than 10 cm H2O in group A and more than 10 cm H2O in group B patients. Changes in lower esophageal pressure after surgery were higher in group B than in group A patients (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Analysis of different factors affecting results of the surgical treatment of gastroesophageal reflux]. 406 95

Experimental achalasia dogs produced with Deloyer's method showed higher resting pressure at the gastroesophageal junction and the increase in LES pressure in response to tetragastrin and cholecystokinin. Dose-response curve of the LES to each dose of tetragastrin in achalasia dog shifted to the left. Resting LES pressure in 11 patients with achalasia was 42.73 +/- 23.31 cm H2O. It increased significantly after intramuscular injection of 5 micrograms/kg of tetragastrin and fluoroscopic observation showed the tonic contraction of the lower esophagus and cardia. After the performance of Jekler-Lhotka operation, LES pressure decreased to lower values sufficient to prevent the gastroesophageal reflux. Comparing 5 kinds of hiatal herniorrhaphies in dogs, LES pressure increased postoperatively in the following order: Nissen, Belsey Mark IV, Stensrud, Hill and Harrington methods. Responses to tetragastrin increased after Nissen and Belsey Mark IV methods. In 12 out of 21 clinical cases of sliding esophageal hiatal hernia who had undergone Nissen-Rossetti method adding fundopexy and posterior gastropexy, preoperative esophageal manometry showed HPZ of 24.98 +/- 8.87 cm H2O in peak value and 5.1 +/- 3.46 cm in length. Seven cases showed the biphasic pattern and 5 cases showed the negative response to tetragastrin. Postoperative manometry showed HPZ of 31.42 +/- 18.46 cm H2O in peak value and 4.5 +/- 1.73 cm in length. One case showed the biphasic pattern and 3 cases showed the negative response to tetragastrin.
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PMID:[Gastrointestinal hormones and operations for achalasia of the esophagus and sliding esophageal hiatal hernia: their surgical significance]. 408 31

The water syphon test is a simple and easily performed method for demonstrating gastro-oesophageal reflux with a high degree of reliability. It is carried out following a conventional barium swallow. Compared with clinical findings and oesophageal manometry, the water syphon test is very reliable for demonstrating gastro-oesophageal reflux during childhood. Prolonged irradiation in order to see spontaneous reflux becomes unnecessary. This results in a significant reduction in radiation dose. Barium swallow and the water syphon test are the most useful initial examinations in children with symptoms which suggest reflux.
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PMID:[Water syphon test and gastro-oesophageal reflux during childhood (correlation with the clinical findings and oesophageal manometry) ]. 621 79

Portal hypertension is defined as an increase of the portal venous pressure over 20 cm H2O or 7 mm Hg, respectively. It may be induced by different types of portal venous stenosis or obstruction, primarily by cirrhosis and fibrosis of the liver and, less frequent by posthepatic disorders such as the Budd-Chiari-syndrome or congestive heart failure. Portal hypertension is followed by ectasia and phlebosclerosis of the portal vein, by splenomegaly, ascites and by various types of collateral circulation. Among these, oesophageal varices, are most important since they often lead to acute upper gastrointestinal haemorrhage, the major complication of portal hypertension. Bleeding from oesophaeal varices is essentially based on atrophy of the squamous epithelium, caused by ischemia from local hypoxia and venous stasis. Portal hypertension and the frequently compromised blood clotting mechanism due to reduced synthesis of clotting factors in the liver aggravate the bleeding. Atrophy of the esophageal mucosa presents an area of decreased resistance likely to ulcerate with easy erosion of the varices--usually lying very superficially--; with mechanical irritation by food or peptic erosion from gastroesophageal reflux being frequent inducers of hemorrhage.
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PMID:[Pathologic-anatomic reflections on portal hypertension (author's transl)]. 624 21

Tc-99m pertechnetate scintigraphy was performed in a patient with Barrett's esophagus and a history of previous lye ingestion. Radionuclide uptake was present in the distal two-thirds of the esophagus and persisted after the drinking of water. This technique is simple and accurate and may be of significant benefit in determining the presence and extent of Barrett's esophagus, which carries an increased incidence of adenocarcinoma development. Examination of patients with chronic gastroesophageal reflux, using this technique, is advocated.
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PMID:Barrett's esophagus complicating lye ingestion. Demonstration by pertechnetate scintigraphy. 631 61

The effect of vasopressin on the lower esophageal sphincter pressure (LESP) is still poorly understood. The present study was designed to determine the effect of I.V. and intra-arterial administration of 8-arginine vasopressin (Pitressin) on the LESP in dogs. A total of 16 anesthetized mongrel dogs were given a continuous perfusion of Pitressin for 20 minutes. Group A (3 dogs): Infused at 2.75 mU/kg/min into the superior mesenteric artery. Group B (3 dogs): 2.75 mU/kg/min into a peripheral vein. Group C (5 dogs): 14 mU/kg/min into a peripheral vein (equivalent to therapeutic dose in humans). Group D (5 dogs): 28 mU/kg/min into a peripheral vein. Esophageal manometry was performed using a triple lumen polyvinyl tube assembly perfused with water at 0.4 ml/min. LESP was checked by the pull-through technique before, immediately and 30 minutes later after termination of the infusion. LESP was monitored at 3 locations during the infusion. No change in LESP was noted when Pitressin (2.75 mU/kg/min) was infused intra-arterial or I.V. I.V. infusion of 14 and 28 mU/kg/min Pitressin caused a significant sustained decrease in LESP (p less than 0.001). After infusion of 28 mU/kg/min, LESP failed to return to control levels in 30 minutes. The results suggest that intravenous administration of a high dose of Pitressin predisposes to gastroesophageal reflux during and shortly after infusion.
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PMID:[Effect of Pitressin (8-arginine vasopressin) on the lower esophageal sphincter in dogs]. 647 51

The mortality rates of two Hungarian settlements with different levels of fluoride concentration in the drinking water are compared for the period 1966-1979. No variations in mortality are observed between the two communities. (summary in ENG, GER, RUS)
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PMID:[Mortality rate, ratio and average age at death in regions with different fluoride concentrations in drinking water]. 657 1

Thirty children without and 15 with gastroesophageal reflux had 1-h gastric emptying rates of water determined by a double dilutional method. The rates were similar in each group at all time intervals. No correlation between age, weight, or surface area and emptying rates was found.
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PMID:Gastric emptying times of water in infants and children: comparison of those with and without gastroesophageal reflux. 664 43

The pathogenesis of oesophagitis associated with ethanol ingestion was studied experimentally by perfusing isolated rabbit oesophagus in situ with 20% and 40% (v/v) ethanol. Since ingestion of ethanol increases duodenogastric and gastro-oesophageal reflux, the effects of HCl and bile salts (in combination with ethanol) were also investigated. The severity of oesophageal mucosal damage was assessed by using transmucosal potential difference, net ion fluxes of H+ and Na+, and mucosal permeability to two neutral molecules of different sizes, 3H-H2O and 14C-erythritol, as indicators of mucosal integrity. Macroscopic changes in the mucosa were also recorded. The results showed that the lower ethanol concentration (20%) is relatively harmless to the oesophageal mucosa. Furthermore, addition of 20% ethanol did not intensify the effects on the mucosa caused by HCl or bile salts alone. In contrast, the stronger ethanol solution (40%) did cause significant mucosal damage when used alone, and this damage was further potentiated by the presence of HCl.
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PMID:Ethanol-induced mucosal injury in rabbit oesophagus. 666 35

A 67-yr-old man with protracted hiccups, as well as reflux esophagitis and a stricture, was found to have heartburn and water brash only during episodes of hiccups. Intraesophageal pH monitoring showed acid gastroesophageal reflux increased during these episodes and decreased with cessation of hiccups. After all attempts failed to relieve his hiccups, a Nissen fundoplication relieved heartburn, healed the esophagitis, and stopped excessive reflux of acid gastric juice, even though the hiccups persisted. These observations showed that reflux provoked by prolonged hiccups could either have adversely affected preexistent reflux esophagitis and stricture or conceivably could have caused these complications.
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PMID:Hiccups associated with reflux esophagitis. 672 62


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