Relationship between acceleration of gastric emptying and oesophageal acid exposure in patients with endoscopy-negative gastro-oesophageal reflux disease

Carmagnola, S.; Fraquelli, Mirella; Cantù, P.; Conte, Dario; Penagini, Roberto

doi:10.1080/00365520500463449

Cited by 14 publications

(12 citation statements)

References 29 publications

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“…Ghrelin has been recently considered a clinical marker of catabolism; caloric intake and chronically positive energy balance suppress ghrelin secretion whereas weight loss and restriction of caloric intake increase ghrelin expression and secretion. 38 Based on these premises, our data seem to support the hypothesis that nutritional status rather than gastric motility influenced the tissue level of ghrelin. chronic heart failure or liver cirrhosis).…”

Section: Discussionsupporting

confidence: 76%

Tissue ghrelin level and gastric emptying rate in adult patients with celiac disease

Rocco

Sarnelli

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et al. 2008

Neurogastroenterology Motil

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Celiac disease (CD) patients show a number of gastrointestinal motor abnormalities. Ghrelin, a gastric peptide implicated in short-term feeding control and long-term body weight regulation, has been recently considered a key regulator of gastric motility. The aim of this study was to evaluate the gastric emptying rate of solids and the density of ghrelin-immunopositive cells in adult CD patients before and at least 1 year after starting a gluten-free diet. Twenty CD patients (M 8/F 12; mean age 36 years) and 10 controls underwent endoscopy with gastric and duodenal biopsies and 13C-octanoic acid breath test to measure gastric emptying of solids. Celiac disease patients repeated the protocol at least 1 year after starting gluten-free diet. Ghrelin tissue levels were evaluated by immunohistochemistry on gastric mucosa specimens. Gastric emptying time was normal in all control subjects (t(1/2) = 89 +/- 16 min) while it was delayed in CD patients prior to gluten-free diet (t(1/2) = 252 +/- 101 min; P < 0.005). The mean number of ghrelin-positive cells/field (x 400) was 14.4 +/- 2.7 in controls and 25.3 +/- 5.7 in CD patients respectively (P < 0.0001). Gluten withdrawal was effective in normalizing gastric emptying time in all CD patients (97 +/- 14 min; P < 0.0001) and resulted in a significant reduction of the density of ghrelin-immunopositive cells (19.8 +/- 5.4; P < 0.0001). The density of ghrelin-positive cells correlated directly with the degree of duodenal damage (P < 0.001) and inversely with the body mass index of CD patients (P < 0.0001). However, in neither CD patients nor controls, a correlation between tissue ghrelin levels and gastric emptying rate was detected. In conclusion, tissue ghrelin level does not correlate with gastric emptying rate in adult CD patients and in controls.

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Section: Discussionsupporting

confidence: 76%

Tissue ghrelin level and gastric emptying rate in adult patients with celiac disease

Rocco

Sarnelli

Compare

et al. 2008

Neurogastroenterology Motil

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“…In fact, recent studies suggest that the pathogenesis of NERD may differ from that of erosive GERD or Barrett’s esophagus [32, 33]. Few clinical studies have evaluated the association between gastric motility and NERD [34]. In the present study, we report that the percentage of NERD patients with a T max value exceeding 65 min is similar to that of PDS patients.…”

Section: Discussionsupporting

confidence: 65%

Comparison of Gastric Emptying and Plasma Ghrelin Levels in Patients with Functional Dyspepsia and Non-Erosive Reflux Disease

et al. 2009

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Background and Aims: The symptoms of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS), the two subtypes of functional dyspepsia (FD) under the new Rome III classification, tend to overlap with those of non-erosive reflux disease (NERD). Plasma ghrelin levels have been associated with gastric motility; however, clinical studies have yet to examine this relationship among patients with PDS, EPS or NERD. Thus, this study aims to evaluate the correlation between gastric emptying and ghrelin levels as possible candidate factors for gastric motility in these diseases. Methods: One hundred and fifty-one patients presenting with typical symptoms of FD (EPS, n = 36; PDS, n = 76) or NERD (n = 39), and 20 healthy volunteers were enrolled. Gastric motility was evaluated with the T_max value as a marker of gastric emptying using the ¹³C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and SRQ-D scores to determine depression status. We measured both acylated and des-acylated ghrelin levels by ELISA methods. Results: The T_max value in PDS patients was significantly higher than in healthy volunteers. Acylated ghrelin levels were significantly lower in NERD and PDS patients than in healthy volunteers. Interestingly, there was significant correlation between the acylated ghrelin levels and T_max value in PDS patients but not in EPS or NERD patients. Conclusion: Our results suggest that acylated ghrelin might play an important role in the pathophysiology of PDS patients through its effect on gastric emptying.

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“…Even as studies on delayed gastric emptying have revealed conflicting results, its role in the development of GERD may be overestimated, as shown in a recent study of patients with endoscopy negative GERD where no relationship between cisapride-induced accelerated gastric emptying and decrease in esophageal acid exposure was reported [96]. Apart from abnormalities in gastric emptying, regional disturbances in gastric motility have also been implicated in the development of GERD, although conflicting results were reported.…”

Section: Gastric Dysmotilitymentioning

confidence: 86%

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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Relationship between acceleration of gastric emptying and oesophageal acid exposure in patients with endoscopy-negative gastro-oesophageal reflux disease

Abstract: The emptying rate of the whole stomach is not a major determinant of gastro-oesophageal reflux.

Cited by 14 publications

References 29 publications

Tissue ghrelin level and gastric emptying rate in adult patients with celiac disease

Tissue ghrelin level and gastric emptying rate in adult patients with celiac disease

Comparison of Gastric Emptying and Plasma Ghrelin Levels in Patients with Functional Dyspepsia and Non-Erosive Reflux Disease

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

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