The relationship between esophageal acid exposure and the esophageal response to volumetric distention

Carlson, Dustin A.; Kathpalia, Priya; Craft, Jenna; Tye, Michael; Lin, Zhiyue; Kahrilas, Peter J.; Pandolfino, John E.

doi:10.1111/nmo.13240

Cited by 41 publications

(35 citation statements)

References 21 publications

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“…However, these findings were not confirmed in a more recent publication but with several limitations like the absence of matching between HV and GERD patients on demographic factors 41 (LE 3). No correlation was found between EGJ DI and reflux parameters including acid exposure time (AET), number of reflux episodes, and longest reflux episodes in one study 42 …”

Section: Resultsmentioning

confidence: 86%

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

Desprez

Roman

Leroi

et al. 2020

Neurogastroenterology Motil

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Background and purpose The EndoFLIP® system is a method of delineating impedance and was first designed to investigate the characteristics of the esophago‐gastric junction. In the last decade, its use was widened to investigate other sphincteric and non‐sphincteric systems of the gastrointestinal tract. The objective of the present systematic review was to summarize the available data in literature on the use of the EndoFLIP® system in the gastrointestinal tract, including sphincteric and non‐sphincteric regions. We performed a systematic review in accordance with recommendations for systematic review using PRISMA guidelines without date restriction, until June 2020, using MEDLINE‐PubMed, Cochrane Library, and Google Scholar databases. Only articles written in English were included in the present review. Five hundred and six unique citations were identified from all database combined. Of those, 95 met the inclusion criteria. There was a lack of standardization among studies in terms of anesthetic drugs use, probe placement, and inflation protocol. In most cases, only small cohorts of patients were included. Most studies investigated the EGJ, with a potential use of the EndoFLIP® to identify a subgroup of patients with achalasia and for intraoperative assessment of treatment efficacy in achalasia. However, the use of EndoFLIP® in the esophageal body (esophageal panometry), other esophageal diseases (gastro‐esophageal reflux disease, eosinophilic esophagitis), and other sphincter regions (anal canal, pylorus) will need further confirmatory studies. The EndoFLIP® system provides detailed geometric data of the gastrointestinal lumen but further works are needed to determine its use in clinical practice.

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Section: Resultsmentioning

confidence: 86%

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

Desprez

Roman

Leroi

et al. 2020

Neurogastroenterology Motil

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“…Thus, although the presence of the RAC pattern has an association with normal motility on HRM and esophageal acid exposure, the normal contractile response appears to be more robust than solely the presence of 3 or more consecutive antegrade contractions. 2,3,15 Therefore, application of added characteristics to quantify the vigor of the contractile response to esophageal distension facilitates the identification of weak or hypercontractile responses when falling outside of normal limits (Table 1). Although specific thresholds will be refined by future studies evaluating esophageal disease states, a weak contractile response may be considered with reduced duration or cessation of the RAC pattern or inability for antegrade contractions to occlude the lumen at fill volumes of 40 mL or greater.…”

Section: Discussionmentioning

confidence: 99%

Normal Values of Esophageal Distensibility and Distension-Induced Contractility Measured by Functional Luminal Imaging Probe Panometry

Carlson

Kou

Lin

et al. 2019

Clinical Gastroenterology and Hepatology

126

143

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Normal parameters of FLIP panometry are EGJ-DI greater than 2.8 mm/mm Hg, DP greater than 18 mm, and antegrade contractions that occur in a repetitive pattern (RACs)-these can be used as normal findings for esophageal distensibility and distension-induced contractility. These values can be used in comparative studies of esophageal diseases, such as achalasia and eosinophilic esophagitis, and will facilitate application of FLIP panometry to clinical practice.

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“…Using a functional lumen imaging probe technique,Carlson et al (2018) did not observe a consistent relationship between gastro-oesophageal junction distensibility and acid exposure, although an impaired oesophageal contractile response to volume distension was confirmed in GORD patients. Using a functional lumen imaging probe technique,Carlson et al (2018) did not observe a consistent relationship between gastro-oesophageal junction distensibility and acid exposure, although an impaired oesophageal contractile response to volume distension was confirmed in GORD patients.…”

mentioning

confidence: 71%

Impairment of rat oesophageal muscle contractility associated with experimental non‐erosive oesophageal mucosal damage

Gadelha

Batista‐Lima

Oliveira

et al. 2018

Experimental Physiology

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New Findings What is the central question of this study?Is the responsiveness of isolated segments of the rat oesophagus to contractile or relaxant stimuli susceptible to acute luminal exposure of the oesophagus to an acid solution that contains pepsin and bile salt? What is the main finding and its importance?The study reveals that luminal acidity is an important factor that disrupts barrier function in the oesophagus to allow the diffusion of noxious agents, such as bile acid, that alter the contractile status of the oesophageal body, even in the absence of inflammation. Abstract We investigated whether the experimental simulation of duodenogastro‐oesophageal reflux alters the contractile responsiveness of rat oesophageal strips. After 30 min of luminal exposure to a solution at acid pH that contained pepsin and taurodeoxycholic acid, isolated strips of the rat oesophagus and gastro‐oesophageal junction were subjected to contractile or relaxing stimuli. Acid challenge decreased the responsiveness of oesophageal strips to contractile stimulation, especially in oesophageal preparations that were mounted following the circular orientation of the muscularis externa layer. The contractility of longitudinal preparations of the rat oesophagus appeared less susceptible to the deleterious effects of acid challenge. In contrast, the responsiveness of ring‐like preparations from the gastro‐oesophageal junction to contractile stimulation was unaltered by acid challenge. Taurodeoxycholic acid decreased the responsiveness of circular oesophageal preparations to KCl, an effect that was exacerbated by luminal acidity. On the contrary, although the relaxant ability of the rat oesophagus did not change, acid challenge increased the relaxant efficacy of sodium nitroprusside and isoprenaline in strips of the gastro‐oesophageal junction. A significant decrease in transepithelial electrical resistance was seen when the oesophageal mucosa was challenged at pH 1 but not at pH 4. Treatment with alginate blunted the deleterious effects of acid challenge on transepithelial electrical resistance and the responsiveness of oesophageal preparations to KCl. The present findings support the notion that luminal acidity is an important factor that disrupts barrier function in the oesophagus to allow the diffusion of noxious agents, such as bile acid, that alter the contractile status of the oesophagus.

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The relationship between esophageal acid exposure and the esophageal response to volumetric distention

Abstract: Abnormal esophageal acid exposure was associated with an impaired contractile response to volume distention of the esophagus. This supports that acid exposure is dependent on acid clearance mechanisms.

Cited by 41 publications

References 21 publications

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

Normal Values of Esophageal Distensibility and Distension-Induced Contractility Measured by Functional Luminal Imaging Probe Panometry

Impairment of rat oesophageal muscle contractility associated with experimental non‐erosive oesophageal mucosal damage

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The relationship between esophageal acid exposure and the esophageal response to volumetric distention

Abstract: Abnormal esophageal acid exposure was associated with an impaired contractile response to volume distention of the esophagus. This supports that acid exposure is dependent on acid clearance mechanisms.

Cited by 41 publications

References 21 publications

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP®) in the gastrointestinal tract: A systematic review

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP®) in the gastrointestinal tract: A systematic review

Normal Values of Esophageal Distensibility and Distension-Induced Contractility Measured by Functional Luminal Imaging Probe Panometry

Impairment of rat oesophageal muscle contractility associated with experimental non‐erosive oesophageal mucosal damage

Contact Info

Product

Resources

About

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP^®) in the gastrointestinal tract: A systematic review