Gastroenterology

Gastroenterology

Volume 89, Issue 4, October 1985, Pages 779-784
Gastroenterology

Gastric distention: A mechanism for postprandial gastroesophageal reflux

https://doi.org/10.1016/0016-5085(85)90572-4Get rights and content

Abstract

The occurrence of gastroesophageal reflux after meals may be related to an increase in the rate of transient lower esophageal sphincter (LES) relaxations, the mechanisms of which are not understood. We investigated the effects of gastric distention on LES pressure in 16 normal subjects and 17 patients with gastroesophageal reflux disease. Intraluminal pressure was measured in the gastric fundus, LES, and esophageal body with a manometric catheter incorporating a sleeve device. Gastric distention was performed by injecting 0, 250, 500, or 750 ml of air in randomized order into a balloon and maintaining each stimulus for 15 min. Gastric distention did not significantly alter resting LES pressure in either group. During the basal period the rate of transient LES relaxation in the reflux patients (1.1 ± 0.4 per 15 min) was greater than that in the normal subjects (0.6 ± 0.1 per 15 min). Gastric distention resulted in a significant threefold to fourfold increase in the rate of transient LES relaxations in both groups. The reflux patients had a significantly greater proportion of complete relaxations (87%) than did the normal subjects (73%). We conclude that gastric distention, by significantly increasing the rate of transient LES relaxations in both normal subjects and patients with gastroesophageal reflux disease, may contribute to the postprandial increase in gastroesophageal reflux.

References (27)

  • SA Muller-Lissner et al.

    Fundic pressure rise lowers lower esophageal sphincter pressure in man

    Hepatogastroenterology

    (1982)
  • DB Skinner et al.

    Assessment of distal esophageal function in patients with hiatal hernia and/or gastroesophageal reflux

    Ann Surg

    (1970)
  • LF Johnson et al.

    Twenty-four hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux

    Am J Gastroenterol

    (1974)
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