TITLE

Severe reflux disease is associated with an enlarged unbuffered proximal gastric acid pocket

AUTHOR(S)
Clarke, A. T.; Wirz, A. A.; Manning, J. J.; Ballantyne, S. A.; Alcom, D. J.; McColl, K. E. L.
PUB. DATE
March 2008
SOURCE
Gut;Mar2008, Vol. 57 Issue 3, p292
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: An unbuffered pocket of highly acidic juice is observed at the gastric cardia after a meal in healthy subjects. Aims: To compare the postprandial acid pocket in healthy subjects and patients with severe reflux disease and define its position relative to anatomical and manometric landmarks. Methods: 12 healthy subjects and 16 patients with severe reflux disease were studied. While fasted, a station pull-through was performed using a combined dual pH and manometry catheter. Position was confirmed by radiological visualisation of endoscopically placed radio-opaque clips. The pull-through study was repeated 15 min after a standardised fatty meal. Barium meal examination was performed before and following the meal. Results: A region of unbuffered acid (pH ⩽ 2) immediately distal to the proximal gastric folds was more frequent in reflux patients (23/32 studies) than in healthy subjects (11/24) (p<0.05). This unbuffered acid pocket was longer in the reflux patients than in the healthy subjects (median length 3 cm (range 1-15) vs 2 cm (range 1-5); p<0.05). The acid pocket extended proximally as far as the proximal gastric folds in the patients but stopped a median of 1.1 cm distal in healthy subjects (p = 0.005). In healthy subjects the acid pocket occupied the distal portion of the sphincter which opened postprandially, whereas in reflux patients it corresponded to the proximal displacement of the gastric folds--that is, hiatus hernia. Conclusion: This enlarged region of unbuffered postprandial acidic juice observed in the patients just below the gastro-oesophageal junction may contribute to the aetiology of severe reflux disease.
ACCESSION #
31301010

 

Related Articles

  • The acid pocket: a target for treatment in reflux disease? Kahrilas, Peter J.; McColl, Kenneth; Fox, Mark; O'Rourke, Lisa; Sifrim, Daniel; Smout, Andre J. P. M.; Boeckxstaens, Guy // South African Gastroenterology Review;Aug2014, Vol. 12 Issue 2, p11 

    The nadir esophageal pH of reflux observed during pH monitoring in the postprandial period is often more acidic than the concomitant intragastric pH. This paradox prompted the discovery of the 'acid pocket', an area of unbuffered gastric acid that accumulates in the proximal stomach after meals...

  • Natural history of branch duct intraductal papillary-mucinous neoplasms of the pancreas without mural nodules: long-term follow-up results. Tanno, S.; Nakano, Y.; Nishikawa, T.; Nakamura, K.; Sasajima, J.; Minoguchi, M.; Mizukami, Y.; Yanagawa, N.; Fujii, T.; Obara, T.; Okumura, T.; Kohgo, Y. // Gut;Mar2008, Vol. 57 Issue 3, p339 

    Background and aim: Although branch duct intraductal papillary-mucinous neoplasms (IPMNs) of the pancreas without mural nodules are frequently observed in asymptomatic subjects, the natural history of these lesions has never been studied. The aim of this study was to elucidate the natural...

  • PEPTÄ°K ÃœLSER SIKLIÄžI AZALIYOR MU? Uyanıkoğlu, Ahmet; Davudoğlu, Can; Çakırca, Mustafa; Danalıoğlu, Ahmet // Nobel Medicus Journal;May-Aug2009, Vol. 5 Issue 2, p15 

    • Objective: The purpose of this trial is to evaluate incidence of peptic ulcer in patients who underwent gatstroscopy for last nine years. • Material and Method: 6063 patients studied, from our Internal Medicine Endoscopy Unit between April 1998 and March 2006 retrospectively....

  • PARTICULARITIES OF MYCOTIC GASTRITIS IN CHILDREN. Ignat, Ancuta; Diaconescu, Smaranda; Lupu, Valeriu V.; Paduraru, Gabriela; Miron, Ingrith; Burlea, Marin // Romanian Journal of Rheumatology;2014, Vol. 23 Issue 2, p168 

    Mycotic gastritis is still an open chapter in specialized research due to the small number of cases described in literature, to its incompletely known complications and prognosis, which creates therapeutic difficulties. The authors report the case of an immune-competent 5 years and 4 months old...

  • Hiatal hernia. Belafsky, Peter C.; Postma, Gregory N.; Koufman, James A. // ENT: Ear, Nose & Throat Journal;Aug2002, Vol. 81 Issue 8, p502 

    Presents the case of a 42-year-old woman diagnosed with hiatal hernia. Background of the disease; Symptoms; Treatment.

  • Incidental diagnosis of hiatus hernia on technetium-99m pertechnetate Meckel's scan. Butt, Sadaf T.; Fatima, Shazia; Jameel, Ghazal; Marwat, Noreen; Irfan, Javaid // Pakistan Journal of Nuclear Medicine;Jan2015, Vol. 5, p67 

    Hiatus hernia is not an uncommon condition. Its true incidence is difficult to estimate since a proportion of the cases are not demonstrated radiologically, and an equal number of clinical diagnoses are made without radiological demonstration. We report a case of a 4-year-old boy being...

  • Role of obesity in GORD-related disorders. El-Serag, Hashem // Gut;Mar2008, Vol. 57 Issue 3, p281 

    Obesity satisfies several criteria for a causal association with GORD and its complications including generally consistent association and some dose--response relationship. Abdominal obesity seems to explain a considerable part of this association operating mostly by increasing intragastric...

  • Capsules.  // Time;7/19/1982, Vol. 120 Issue 3, p71 

    The article offers updates on medical research. Entomologists Brian Federici and Mir Mulla of University of California, Riverside had developed an insecticide from bacillus thuringiensis israelensis (BTI), which is lethal to mosquitoes. Researchers of University of California, San Diego had...

  • SYMPOSIUM ON THE ESOPHAGUS.  // American Journal of Gastroenterology;Jun1964, Vol. 41 Issue 6, p587 

    Presents a transcript of the discussion on the esophagus, that was presented before the 28th Annual Convention of the American College of Gastroenterology in Washington, D.C. in October 1963. Diagnosis of hiatal hernia; Importance of intraabdominal esophagus to the prevention of...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics