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)

Although there were many reports on gastric emptying in patients with gastroesophageal reflux disease (GERD) in western country, there was no scientific paper about it in Chinese. In 22 cases of GERD, diagnosed by clinical manifestations, endoscopy, histology and 24-hour pH monitoring in the distal portion of esophagus, gastric liquid emptying was measured by using absorption test. The results suggested that the mean time to reach the peak of the serum paracetamol level after taking 500ml water was 34.02 +/- 9.09 min. in 13 healthy adults and 51.14 +/- 23.35 min. in 22 cases of GERD. The difference between the two groups was significant (P < 0.02). Among these 22 patients, 12(54.54%) had delayed gastric emptying, 1 rapid and 9 normal. Our data confirmed that gastric liquid emptying was delayed in some patients with GERD.
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PMID:[Delayed gastric liquid emptying in the patients with gastroesophageal reflux disease]. 811 43

The impact of stress on gastroesophageal reflux and antireflux mechanisms remains largely unexplored. To a major extent, reflux depends on a balance between gastroesophageal junction resistance to flow and gastric tone. We hypothesized that these two forces could be differently affected by stress, and to test the hypothesis we quantified in 10 healthy volunteers the effect of an acute stressful stimulus (cold pain) upon both gastroesophageal junction resistance (measured by a pneumatic resistometer) and gastric tone (measured by an electronic barostat). Such measurements were performed both under basal conditions and during stress stimulation (hand immersion in cold water for 5 min), on two separate days. The cardiovascular autonomic response was simultaneously monitored as changes in blood pressure and pulse rate. We found that, taken as a whole, cold stress significantly decreased gastroesophageal resistance (flow increase from 347 +/- 29 ml/min to 526 +/- 58 ml/min) as well as gastric tone (volume increase from 147 +/- 10 ml to 218 +/- 17 ml) (P < 0.02 for both). However, responses showed marked intra- and interindividual variation. Moreover, we found no relationship between changes in resistance to flow at the junction and either the cardiovascular autonomic response or the discomfort produced by cold stress. Changes in gastric tone were similarly unrelated to autonomic and perceptive responses. We conclude that in man experimental stress induced by cold pain tends to disrupt each of two opposite mechanisms that control gastroesophageal reflux: gastroesophageal resistance to flow and gastric tone. However, since both are decreased by stress, gastroesophageal function is largely maintained.
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PMID:Effect of experimental cold pain stress on gastroesophageal junction. 813 3

Bicarbonate-calcic water Ferrarelle has been administered both in the fasting state and during meals to patients suffering from gastro-esophageal reflux disease submitted to computerized pHmetry. Marked and lasting increase of esophageal and gastric pH was observed with significant differences from the effect of tap water. In addition, patients reported improvement of heart burn and acidity after the administration of the bicarbonate-calcic water. The alkalizing effect of the mineral water employed is therefore fully confirmed.
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PMID:[Alkalizing activity of a calcium-bicarbonate-containing water, evaluated for pH, in patients with gastroesophageal reflux]. 822 43

Gastroesophageal reflux (GER) frequently complicates the clinical course of children suffering from conditions leading to upper airway obstruction (UAO) (choanal atresia, tracheomalacia, esophageal atresia, vascular rings, etc). In an attempt to explore whether partial airway obstruction causes changes in the normal thoracoabdominal pressure gradients, we measured end-inspiratory intrathoracic and intraabdominal pressures in anesthetized rats under spontaneous breathing conditions, after tracheostomy, and under upper airway obstruction induced by tracheal intubation with three progressively narrower cannulae (inner diameters 1.0 mm, 0.5 mm, and 0.2 mm). We also measured the lower esophageal sphincter pressure (LESP) and length (LESL) and calculated the thoracoabdominal end-inspiratory pressure gradient (TAEIPG). Neither LESP nor LESL changed significantly before or after maximal tracheal obstruction (14.3 +/- 6.2 v 18 +/- 7.6 cm H2O [P > .05] and 0.34 +/- 0.09 v 0.41 +/- 0.1 cm H2O [P > .05] respectively) but TAEIPG significantly increased from 5.58 +/- 1.34 cm H2O to 17.62 +/- 4.27 cm H2O (P < .01) under the same conditions, mainly as a result of progressively increasing negative intrathoracic pressures during inspiration. These experiments prove that the powerful thoracoabdominal pressure gradients developed after partial UAO may contribute to the pathogenesis of GER by overcoming the antireflux barrier function. This study points out the convenience of routinely screening for GER all children with airway obstructive conditions, bearing in mind that the reestablishment of normal respiratory conditions should be the primary goal of treatment.
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PMID:Airway obstruction and gastroesophageal reflux: an experimental study on the pathogenesis of this association. 822 6

Nasal continuous positive airway pressure (CPAP) reduces nocturnal gastroesophageal reflux (GER) in obstructive sleep apnea syndrome (OSAS) patients. The primary objectives of our investigation were to determine if CPAP could reduce reflux in non-OSAS patients and, if so, by what mechanism. Esophageal pH was monitored for 48 h in six nocturnal reflux patients. During the first 24 h, basal reflux data were collected; the second night, nasal CPAP was administered (pressure = 8 cm H2O). Esophageal manometry was obtained in six healthy adult volunteers both on and off nasal CPAP (pressure = 8 cm H2O) to ascertain CPAP's effects on esophageal pressure and peristalsis. The six reflux patients experienced less nocturnal GER while on CPAP. The mean percent time esophageal pH < 4 was reduced from 27.7 +/- 10.0 to 5.8 +/- 2.6 (p < 0.004); the mean reflux duration dropped from 2.1 +/- 0.6 to 0.9 +/- 0.5 min (p < 0.03); and the mean duration of longest reflux improved from 84.3 +/- 32.6 to 13.8 +/- 6.9 min (p < 0.01). The CPAP raised the mean resting midesophageal pressure by 4.4 cm H2O (p < 0.01) and the mean resting lower esophageal pressure (LES) by 13.2 cm H2O (p < 0.02) in the healthy volunteers. Nasal CPAP effectively reduced nocturnal GER in six patients with nocturnal reflux. The antireflux activity of CPAP is likely due to passive elevation of intraesophageal pressure and possibly to reflex LES constriction.
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PMID:Nasal continuous positive airway pressure. A new treatment for nocturnal gastroesophageal reflux? 830 10

Gastro-oesophageal reflux (GER) frequently complicates the clinical course of children suffering from conditions leading to upper airway obstruction (UAO) (choanal atresia, tracheomalacia, oesophageal atresia, vascular rings etc.). In an attempt to explore whether partial airway obstruction causes changes in the normal thoraco-abdominal pressure gradients, we measured end-inspiratory intrathoracic and intra-abdominal pressures in anesthesized rats under spontaneous breathing conditions, after tracheostomy and under upper airway obstruction induced by tracheal intubation with three progressively narrower cannulae (inner diameters 1.0 mm, 0.5 mm. and 0.2 mm.). We also measured the lower oesophageal sphincter pressure (LESP) and length (LESL) and calculated the thoraco-abdominal end-inspiratory pressure gradient (TAEIPG). Neither LESP nor LESL changed significantly before or after maximal tracheal obstruction but TAEIPG significantly increased from 5.58 +/- 1.34 cm H2O to 17.62 +/- 4.27 cm. H2O (p < 0.01) under the same conditions, mainly as a result of progressively stronger intra-thoracic pressures during inspiration. These experiments prove that the powerful thoraco-abdominal pressure gradients developed after partial UAO may contribute to the pathogenesis of GER by overcoming the anti-reflux barrier function.
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PMID:[Airway obstruction associated with gastroesophageal reflux: experimental study]. 835 28

Previous studies have demonstrated an increased gastroesophageal reflux after the ingestion of high-proof alcoholic beverages in normal subjects. Data on gastroesophageal reflux with usual amounts of low-proof alcoholic beverages are not available. The effect of white wine (7.5% v/v, pH 3.2) and beer (7.0% v/v, pH 4.5) was compared with water, a nonalcoholic beverage of pH 3.2, and an ethanol solution (7.5% v/v, pH 7.6) using ambulatory pH measurement in healthy volunteers. The fraction of time at pH < 4 in the first hour after ingestion of 300 ml white wine (median 13.2%) was significantly increased compared with beer (3.6%; P < 0.01), water (0.9%; P < 0.001), ethanol (1.3%; P < 0.001), and the nonalcoholic beverage (0.9%; P < 0.05). Beer provoked significantly more gastroesophageal reflux than water (P < 0.01). It is concluded that white wine and beer induce gastroesophageal reflux, which is neither related to their ethanol content nor to their pH. The mechanism for this effect remains to be identified.
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PMID:Low-proof alcoholic beverages and gastroesophageal reflux. 842 Jul 65

We report an unusual presentation of gastroesophageal reflux disease in a 14-yr-old boy with cervical dysphagia and vomiting immediately after swallowing. Reflux disease was diagnosed by the combination of eosinophils on esophageal biopsies and abnormal 24-h pH results. The cervical site of dysphagia demonstrated acid-induced hypersensitivity to esophageal distension with water or air. The patient's symptoms resolved with marked acid suppression, which was made difficult because intact capsules of omeprazole initially could not be ingested.
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PMID:Unusual presentation of mucosal hypersensitivity secondary to gastroesophageal reflux disease. 842 36

This study evaluates the yield pressure at the gastroesophageal junction in a group of 73 patients undergoing diagnostic endoscopy and in another group of 82 patients during the course of manometry for suspected GERD. The group included 17 patients who had previously undergone a successful Nissen fundoplication and eight patients who had a failed Nissen fundoplication. Air is insufflated into the stomach, and a water perfused pressure transducer is used to detect intragastric pressure. The pressure at which the cardia was seen to open at endoscopy, or when a common cavity phenomenon was detected at manometry, was taken as the opening pressure. Yield pressure was calculated as the difference between the opening pressure of the cardia and the resting gastric pressure. Results indicated a significant decrease in yield pressure in 65 patients with esophagitis compared with 65 patients with no evidence of reflux or esophagitis. A significant inverse correlation was found between yield pressure and the size of the hiatus hernia noted in these patients. There was also a correlation between valvular appearance of the cardia at endoscopy and the yield pressure. A progressive decrease in yield pressure occurred with an increasing deterioration in the physical appearance of the valve. There was no significant relationship found between yield pressure and lower esophageal sphincter (LES) pressure or intra-abdominal length. A small but significant relationship was found between yield pressure and acid exposure of the lower esophagus. The 17 patients with a successful Nissen showed a significantly increased yield pressure to supranormal values. In contrast, the eight patients with a failed Nissen had yield pressures within the range of the patients with esophagitis. In eight patients, yield pressure was measured by both manometry and endoscopy and showed no significant differences between the two methods.
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PMID:Yield pressure: a new concept in the evaluation of GERD? 863 30

Gastroesophageal reflux (GER) often occurs in babies receiving respiratory assistance for neonatal distress. The authors examined the lower esophageal sphincter and the thoracic and abdominal pressure conditions in rats under progressively higher continuous positive airway pressure (CPAP) to test the efficacy of the antireflux barrier under such conditions. Intrathoracic and intraabdominal pressures were recorded within the esophagus and within the inferior vena cava in 10 anesthesized 250-g male rats. Pull-through techniques were used for lower esophageal sphincter pressure (LESP) and length (LESL) studies, and the length of the intraabdominal segment of the esophagus (LIASE) was also determined. Measurements were performed in baseline conditions and at CPAP levels of 0, 1, 3, 5 and 7 cm H2O. The respiratory effort progressively increased with prolonged expiration and decreased frequency. LESP and LESL did not change significantly, but the antireflux barrier was weakened by a progressive shortening of LIASE. Successive CPAP increases led to increasingly negative thoracic pressures during inspiration, and increasingly positive abdominal pressure during expiration yielded progressively greater transdiaphragmatic pressure gradients. The authors suggest that CPAP weakens the antireflux barrier and, at the same time, increases the gastroesophageal pressure gradient, thus increasing the risk of GER. Although transpolation of experimental data to the clinical setting is always hazardous, the authors believe this issue should be investigates in infants.
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PMID:[Gastroesophageal reflux and ventilation with continuous positive pressure. Experimental study]. 896 3


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