Dynamic Characteristics of Gastro-oesophageal Reflux in Ambulatory Patients with Gastro-oesophageal Reflux Disease and Normal Control Subjects

Abstract

The dynamic characteristics of pathologic reflux differ significantly from those of physiologic reflux.

Effect of endoscopic augmentation of the lower oesophageal sphincter (Gatekeeper reflux repair system) on intraoesophageal dynamic characteristics of acid reflux

“…Data for pH variables according to body position in patients confirm previous findings that most of the reflux episodes occur and reach the proximal oesophagus while in an upright position but mean duration is longer in the supine position. 21 The longer duration of reflux events in the supine position, reported to be a pathophysiological marker of GORD patients, was no longer present at follow up.…”

Review article: acidity and volume of the refluxate in the genesis of gastro‐oesophageal reflux disease symptoms

“…More than a decade ago, Weusten and colleagues studied the proximal extent of acidic reflux in the oesophagus of healthy subjects and patients with reflux disease, using a catheter fitted with five ion-sensitive field effect transistor (ISFET) pH sensors. [32][33][34][35] The catheter used measured pH at 3, 6, 9, 12 and 15 cm above the lower oesophageal sphincter (LES). In healthy subjects there was a linear decline in acid exposure values from distal to proximal, i.e.…”

The acid pocket and its relevance to reflux disease

“…pH monitoring has shown over double the rate of detection of acid reflux in this region compared with 5 cm, and up to six times higher within the LOS segment itself 17. The rate of reflux episodes detected in the most distal oesophagus is also higher in patients with reflux disease than in controls 18 19. Given the proximity of the acid pocket to the distal border of the LOS, and evidence that it might even extend into the distal LOS segment because of meal-induced opening of the distal segment of the LOS, it is possible that continued high levels of acidity at the cardia might have a greater impact on acid exposure in the very distal oesophagus than more proximally.…”