SUMMARY BackgroundEndoscopic balloon dilation has been shown to be an alternative to surgery in the treatment of Crohn's symptomatic strictures.

Small-intestinal motility is frequently but not universally abnormal in diarrhea-predominant IBS. The abnormal manometric findings are heterogeneous and range from subtle quantitative changes to severe qualitative abnormalities resembling chronic idiopathic intestinal pseudo-obstruction in a small subset of patients.

Rhythm generation in mature respiratory networks is influenced strongly by synaptic inhibition. In early neonates, GABAA‐receptor‐ and glycine‐receptor‐mediated inhibition is not present, thus the question arises as to whether GABAB‐receptor‐mediated inhibition plays an important role. Using brainstem slices of neonatal mice (postnatal day, P0‐P15), we analysed the role of GABAB‐mediated modulation of GABA and glycine synaptic transmission in the respiratory network. Blockade of GABA uptake by nipecotic acid (0.25–2 mm) reduced the respiratory frequency. This reduction was prevented by the selective GABAB receptor antagonist CGP55845A (CGP) alone at P0‐P3, but by bicuculline as well as CGP at P7‐P15. Blockade of GABAB receptors by CGP increased the respiratory frequency at P0‐P3, whereas it caused a reduction of frequency in older animals. The effect of CGP on respiratory frequency was diminished in the presence of bicuculline and strychnine in older but not in younger animals. The relative contribution of GABAB‐receptor‐mediated pre‐ and postsynaptic modulation was examined by analysing the effect of GABAB receptors on spontaneous and miniature IPSCs. In younger animals (P0‐P3), the GABAB receptor agonist baclofen had no detectable effect on IPSC frequency, but caused a significant decrease in the amplitude. In older animals (P7‐P15), baclofen decreased both the frequency and amplitude of spontaneous and miniature IPSCs. These results demonstrate that GABAB‐receptor‐mediated postsynaptic modulation plays an important role in the respiratory network from P0 on. GABAB‐receptor‐mediated presynaptic modulation develops with a longer postnatal latency, and becomes predominant within the first postnatal week.

No abstract

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.