Review article: the clinical relevance of transient lower oesophageal sphincter relaxations in gastro-oesophageal reflux disease

Kessing, Boudewijn F.; Conchillo, José M.; Bredenoord, Albert J.; Smout, A. J. P. M.; Masclee, Ad

doi:10.1111/j.1365-2036.2010.04565.x

Cited by 53 publications

(47 citation statements)

References 125 publications

(170 reference statements)

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“…Thus the objective criteria used to identify TLESR during our experiments were based on the manometric profile of the LES (8) . This technique enables continuous measurement of LES pressure and leading to a better comprehension of GERD, by identifying TLESR as the main permissive mechanism for GERD (18) .…”

Section: Discussionmentioning

confidence: 99%

The Participation of the Nitrergic Pathway in Increased Rate of Transitory Relaxation of Lower Esophageal Sphincter Induced by Rectal Distension in Dogs

Palheta

Graça

Santos

et al. 2014

Arq. Gastroenterol.

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ContextThe rectal distension in dogs increases the rate of transitory lower esophageal sphincter relaxation considered the main factor causing gastroesophageal reflux.ObjectivesThe aim of this study was evaluate the participation of the nitrergic pathway in the increased transitory lower esophageal sphincter relaxation rate induced by rectal distension in anesthetized dogs.MethodsMale mongrel dogs (n = 21), weighing 10-15 kg, were fasted for 12 hours, with water ad libitum. Thereafter, they were anesthetized (ketamine 10 mg.Kg-1+ xylazine 20 mg.Kg-1), so as to carry out the esophageal motility evaluation protocol during 120 min. After a 30-minute basal period, the animals were randomly intravenous treated whith: saline solution 0.15M (1ml.Kg-1), L-NAME (3 mg.Kg-1), L-NAME (3 mg.Kg-1) + L-Arginine (200 mg.Kg-1), glibenclamide (1 mg.Kg-1) or methylene blue (3 mg.Kg-1). Forty-five min after these pre-treatments, the rectum was distended (rectal distension, 5 mL.Kg-1) or not (control) with a latex balloon, with changes in the esophageal motility recorded over 45 min. Data were analyzed using ANOVA followed by Student Newman-Keuls test.ResultsIn comparison to the respective control group, rectal distension induces an increase in transitory lower esophageal sphincter relaxation. Pre-treatment with L-NAME or methylene blue prevents (P<0.05) this phenomenon, which is reversible by L-Arginine plus L-NAME. However, pretreating with glibenclamide failed to abolish this process.ConclusionsTherefore, these experiments suggested, that rectal distension increases transitory lower esophageal sphincter relaxation in dogs via through nitrergic pathways.

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Section: Discussionmentioning

confidence: 99%

The Participation of the Nitrergic Pathway in Increased Rate of Transitory Relaxation of Lower Esophageal Sphincter Induced by Rectal Distension in Dogs

Palheta

Graça

Santos

et al. 2014

Arq. Gastroenterol.

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“…The most important mechanism is the failure of the anti-reflux barrier, known as lower esophageal sphincter (LES), which is composed by the own esophageal muscle and the diaphragmatic crus. The transient LES relaxation (TLESRs) triggered during post-prandial gastric distension is the main event during which the gastric content is propelled into the esophagus [8,9]. Furthermore, several risk factors have been associated with GERD, in particular obesity, dietary habits and emotional disturbances [10].…”

Section: Pathophysiologymentioning

confidence: 99%

Gastroesophageal Reflux Disease and Dental Erosions - A Mini Review

Fornari¹

2017

GHOA

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Gastroesophageal reflux disease (GERD) has an established association with dental erosions. Patients with GERD may have chronic exposition of the oral cavity to acid reflux, which may damage the dental surface of either deciduous or permanent teeth. A multidisciplinary approach involving dental surgeons and physicians is needed to diagnose and treat GERD and dental erosions, preferentially in their early stage.

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“…Many receptors in central nervous system is involved in TLESR, hence several approaches for TLESR inhibitors mediated through GABAB, metabolic glutamine (mGlu) and cannabinoid (CB) receptors have been developed to enhance the lower esophageal sphincter constriction for blocking the gastric acid and non-acid reflux. Although GABAB receptor agonist (baclofen, R-baclofen, AZD9343, lesogaberan: AZD3355), mGlu receptor 5 antagonist (ADX10059, AZD2066, AZD2516) and CB1 agonist (D9-THC) reduced the TLESR, central nerve side effects such as headache and drowsiness, and low compliance (need to be taken twice or three times a day) were observed in clinical studies [Blondeau, 2010;Kessing et al, 2011]. Lesogaberan which was administered twice daily as add-on treatment to PPI ameliorated heartburn and regurgitation symptoms in persistent GERD symptoms even daily PPI therapy [Boeckxstaens et al, 2011]; however these effects were not adequate.…”

Section: Tlesr Inhibitormentioning

confidence: 99%

“…TLESR is an episode of lower esophageal relaxation that occurs unrelated to swallowing [Kessing et al, 2011], and it is considered to be the underlying refractory factors for GERD treatment with PPIs. Many receptors in central nervous system is involved in TLESR, hence several approaches for TLESR inhibitors mediated through GABAB, metabolic glutamine (mGlu) and cannabinoid (CB) receptors have been developed to enhance the lower esophageal sphincter constriction for blocking the gastric acid and non-acid reflux.…”

Section: Tlesr Inhibitormentioning

confidence: 99%

E3710, Long-Acting PPI as New Approach for the Treatment of Unmet Medical Needs for GERD

Kodama¹,

Fujisaki²,

Tonomura³

et al. 2012

Gastroesophageal Reflux Disease

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Review article: the clinical relevance of transient lower oesophageal sphincter relaxations in gastro-oesophageal reflux disease

Cited by 53 publications

References 125 publications

The Participation of the Nitrergic Pathway in Increased Rate of Transitory Relaxation of Lower Esophageal Sphincter Induced by Rectal Distension in Dogs

The Participation of the Nitrergic Pathway in Increased Rate of Transitory Relaxation of Lower Esophageal Sphincter Induced by Rectal Distension in Dogs

Gastroesophageal Reflux Disease and Dental Erosions - A Mini Review

E3710, Long-Acting PPI as New Approach for the Treatment of Unmet Medical Needs for GERD

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