| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
D Sifrim
a Centre for
Gastroenterological Research, University of Leuven, Leuven, Belgium, b Helmoltz-Institute for Biomedical Engineering,
Aachen, Germany, c Department of
Gastroenterology, Royal Adelaide Hospital, Adelaide, South Australia
Correspondence to: Dr D Sifrim,
Faculty of Medicine KU Leuven, Lab G-I Physiopathology, O&N
Gasthuisberg, 7th floor, Herestraat 49, 3000 Leuven, Belgium. Accepted for publication 22 July 1998
Background Keywords:
belching;
gastro-oesophageal reflux disease;
oesophageal manometry;
intraluminal electrical impedance;
lower
oesophageal sphincter
Belching has been
proposed as a major mechanism underlying acid gastro-oesophageal reflux
in normal subjects. However, the presence of oesophageal gas has
not been measured directly but only inferred from manometry.
AimsTo investigate, using
intraluminal electrical impedance, the patterns of gas and liquid
reflux during transient lower oesophageal sphincter (LOS) relaxations,
the main mechanism of acid reflux in normal subjects.
MethodsImpedance changes
associated with the passage of gas were studied in vitro, and in vivo
in cats. Oesophageal manometry, pH, and intraluminal electrical
impedance measurements were performed in 11 normal subjects after a meal.
ResultsGas reflux caused a
sudden increase in impedance that propagated rapidly to the proximal
oesophagus whereas liquid reflux induced a retrogressively propagated
fall in impedance. Impedance showed gas or liquid reflux during most
(102/141) transient LOS relaxations. When acid reflux occurred,
impedance showed evidence of intraoesophageal retrograde flow of liquid
in the majority (78%) of events. Evidence of gas retroflow was found
in almost half (47%) of acid reflux episodes. When present together,
however, liquid preceded gas on 44% of occasions. Overall, gas reflux
occurred as the initial event in only 25% of acid reflux episodes.
ConclusionsThese findings suggest
that in upright normal subjects, although belching can precipitate acid
reflux, most acid reflux occurs as a primary event.
(GUT 1998;44:47-54)
This article has been cited by other articles:
|
|
 |
|
  A J Bredenoord, W A Draaisma, B L A M Weusten, H G Gooszen, and A J P M Smout Mechanisms of acid, weakly acidic and gas reflux after anti-reflux surgery Gut, February 1, 2008; 57(2): 161 - 166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. A. Tipnis, J. Liu, J. L. Puckett, and R. K. Mittal Common cavity pressure during gastroesophageal reflux: reassessment using simultaneous pressure, impedance, and ultrasound imaging Am J Physiol Gastrointest Liver Physiol, June 1, 2006; 290(6): G1149 - G1156. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. I. Omari, N. Rommel, M. M. Szczesniak, S. Fuentealba, P. G. Dinning, G. P. Davidson, and I. J. Cook Assessment of intraluminal impedance for the detection of pharyngeal bolus flow during swallowing in healthy adults Am J Physiol Gastrointest Liver Physiol, January 1, 2006; 290(1): G183 - G188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A J Bredenoord, B L A M Weusten, D Sifrim, R Timmer, and A J P M Smout Aerophagia, gastric, and supragastric belching: a study using intraluminal electrical impedance monitoring Gut, November 1, 2004; 53(11): 1561 - 1565. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Sifrim, D Castell, J Dent, and P J Kahrilas Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux Gut, July 1, 2004; 53(7): 1024 - 1031. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. F. Poets Gastroesophageal Reflux: A Critical Review of Its Role in Preterm Infants Pediatrics, February 1, 2004; 113(2): e128 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Savoye-Collet, G. Savoye, and A. Smout Determinants of transpyloric fluid transport: a study using combined real-time ultrasound, manometry, and impedance recording Am J Physiol Gastrointest Liver Physiol, December 1, 2003; 285(6): G1147 - G1152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Simren, J Silny, R Holloway, J Tack, J Janssens, and D Sifrim Relevance of ineffective oesophageal motility during oesophageal acid clearance Gut, June 1, 2003; 52(6): 784 - 790. [Abstract] [Full Text]
|
|
|
|
|
|
G. Savoye, C. Savoye-Collet, J. Oors, and A. J. P. M. Smout Interdigestive transpyloric fluid transport assessed by intraluminal impedance recording Am J Physiol Gastrointest Liver Physiol, April 1, 2003; 284(4): G663 - G669. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.-L. Rhee, J. Liu, J. L. Puckett, and R. K. Mittal Measuring esophageal distension by high-frequency intraluminal ultrasound probe Am J Physiol Gastrointest Liver Physiol, October 1, 2002; 283(4): G886 - G892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Pandolfino, G. Shi, J. Curry, R. J. Joehl, J. G. Brasseur, and P. J. Kahrilas Esophagogastric junction distensibility: a factor contributing to sphincter incompetence Am J Physiol Gastrointest Liver Physiol, June 1, 2002; 282(6): G1052 - G1058. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
