Provocation of transient lower esophageal sphincter relaxations by gastric distension with air

Straathof, Jan Willem; Ringers, J.; Lamers, C. B. H. W.; Masclee, Ad

doi:10.1111/j.1572-0241.2001.03935.x

Cited by 51 publications

(50 citation statements)

References 19 publications

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“…Risk factors for gastro-oesophageal reflux include smoking, obesity, alcohol consumption [7], physical inactivity and dietary factors [8]. Previous studies also suggested that gastric distention by gas or liquid boluses could cause transient relaxation of the lower oesophageal sphincter which is likely to increase frequency of reflux episodes [9,10]. Although, reflux of liquid stomach contents is most likely to result in measurable reflux, previous hypothesis has also suggested that the retrograde movement of gas boluses could also coat the mucosal lining of the aerodigestive tract with small volumes of aerosolized gastric juice [10].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Acute Effects of Carbonated Beverage Consumption on Symptoms and Objective Markers of Gastric Reflux

Lim

2018

Gastrointestinal Disorders

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Previous studies have suggested that carbonated beverages may cause gastro-oesophageal reflux. Pepsin (the major enzyme secreted by the stomach) has been suggested to be an objective, acute marker of a reflux event. This pilot study aimed to investigate whether intake of carbonated beverages could affect pepsin concentration in saliva or reflux symptoms. This was assessed by a randomised, crossover trial where participants consumed 330 mL of beverage (carbonated cola, degassed cola or water) at separate visits. Saliva samples and symptom questionnaires were collected at baseline and over the 30 min postprandial period. Pepsin was detected in all saliva samples. No difference was found in the salivary pepsin concentrations between treatments at all time points. There were significantly higher scores (p > 0.05) for feelings of fullness, heartburn, urge to belch and frequency of belches after ingestion of carbonated cola than degassed cola and water. The ingestion of carbonated beverages did not appear to increase postprandial pepsin concentration in saliva compared to other beverages but did evoke higher levels of reflux-related symptoms such as fullness, heartburn and belching. This suggests carbonated beverages may cause symptoms associated with reflux but do not drive detectable levels of gastric juice to reach the oral cavity.

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Section: Introductionmentioning

confidence: 99%

Assessment of the Acute Effects of Carbonated Beverage Consumption on Symptoms and Objective Markers of Gastric Reflux

Lim

2018

Gastrointestinal Disorders

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“…A number of studies have shown delayed gastric emptying in patients with GERD [80,81,82,83,84,85]. In theory, delayed gastric emptying could lead to accumulation of a larger intragastric volume of solids and liquids leading to reflux [86] or the resultant gastric distension may provoke more TLESRs [36, 87, 88], possibly through activation of gastric mechanoreceptors [37,38,39, 89, 90]. On the other hand, several studies have failed to show a correlation between delayed gastric emptying and increased gastroesophageal reflux.…”

Section: Gastric Dysmotilitymentioning

confidence: 99%

The Spectrum of Motor Function Abnormalities in Gastroesophageal Reflux Disease and Barrett’s Esophagus

et al. 2009

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Barrett’s esophagus has traditionally been regarded as the most severe end of the spectrum of gastroesophageal reflux disease and is of great clinical importance in view of the association with esophageal adenocarcinoma. Studies have documented high levels of esophageal acid exposure in Barrett’s esophagus. Various pathogenetic mechanisms underlie this phenomenon. These include abnormalities in esophageal peristalsis, defective lower esophageal sphincter pressures, gastric dysmotility and bile reflux. Whilst these factors provide evidence for an acquired cause of Barrett’s esophagus, an underlying genetic predisposition cannot be ruled out. Although the past decade has brought about many new discoveries in the pathogenesis of Barrett’s esophagus, it has also added further controversy to this complex disorder. A detailed analysis of the gastrointestinal motor abnormalities occurring in Barrett’s esophagus follows, with a review of the currently available literature and an update on this condition that continues to be of interest to the gastroenterologist.

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“…Our group previously reported more GER events during wake-state 26 and attributed it to a higher frequency of transient lower esophageal sphincter relaxation and postprandial gastric distention 27 during wake-state. However during our analysis of pH studies, meal periods were appropriately excluded.…”

Section: Discussionmentioning

confidence: 83%

Effect of Severity of Esophageal Acidification on Sleep vs Wake Periods in Infants Presenting with Brief Resolved Unexplained Events

Sankaran

Qureshi

Woodley

et al. 2016

The Journal of Pediatrics

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Objectives To describe the pattern of gastro-esophageal reflux (GER) events in wake and sleep states with increasing acid reflux index (ARI) in neonates and to test the hypothesis that GER-related symptoms are frequent in ARI> 7% in wake-state. Study design Infants underwent 24-hour pH-impedance studies with 6-hour concurrent video-polysomnography studies. Data were stratified based on the 24-hr ARI (% duration that esophageal pH is <4) into ARI<3% (normal), ARI 3≥ to ≤7% (intermediate) and ARI>7% (abnormal). GER frequency, clearance mechanisms and symptoms were distinguished during wake-state and sleep-state. Results Total wake and sleep duration was similar (p≥ 0.2) in all ARI groups. Acidic events were frequent with increasing ARI in wake-state vs. sleep-state (p≤ 0.03). The Symptom Index increased with increasing ARI (p≤ 0.02) in both wake-state and sleep-state. Acid clearance time increased with increasing ARI in wake-state (p≤ 0.02). In ARI>7% vs. ARI≤7%, frequency of acidic GER events was higher (p≤0.02) in wake-state and sleep-state; proximal migration of acid (p=0.03) and acid clearance time were higher in wake-state (p=0.0005) only. Symptom index was higher in ARI>7% vs. ARI≤7% in wake-state (p<0.0001), comparable in normal vs. intermediate (p=0.4) and higher in abnormal vs. intermediate (p=0.0004) groups. Conclusions Severe esophageal acid exposure (ARI>7%) is associated with increased reflux-associated symptoms in wake-state. Sleep-state appears to be protective regardless of ARI, likely due to greater chemosensory thresholds. Attention to posture and movements during wake-state can be helpful. Scrutiny for non-GER etiologies should occur for infants presenting with life-threatening symptoms.

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Provocation of transient lower esophageal sphincter relaxations by gastric distension with air

Abstract: Short-lasting gastric air distension 1) provokes TLESRs but does not differentiate GERD patients from controls, 2) reveals impaired belching capacity in patients after complete fundoplication, and 3) shows that common cavities do not exclusively occur during TLESRs.

Cited by 51 publications

References 19 publications

Assessment of the Acute Effects of Carbonated Beverage Consumption on Symptoms and Objective Markers of Gastric Reflux

Assessment of the Acute Effects of Carbonated Beverage Consumption on Symptoms and Objective Markers of Gastric Reflux

The Spectrum of Motor Function Abnormalities in Gastroesophageal Reflux Disease and Barrett’s Esophagus

Effect of Severity of Esophageal Acidification on Sleep vs Wake Periods in Infants Presenting with Brief Resolved Unexplained Events

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