TITLE

Presence of gas in the refluxate enhances reflux perception in non-erosive patients with physiological acid exposure of the oesophagus

AUTHOR(S)

Emerenziani, S.; Sifrim, D.; Habib, F. I.; Ribolsi, M.; Guarino, M. P. L.; Rizzi, M.; Caviglia, A.; Petitti, T.; Cicala, M.

PUB. DATE

April 2008

SOURCE

Gut;Apr2008, Vol. 57 Issue 4, p443

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

ABSTRACT

Objective: The mechanisms underlying symptoms in gastro-oesophageal reflux disease, particularly in non-erosive reflux disease (NERD), remain to be fully elucidated. Weakly acidic reflux and the presence of gas in the refluxate could be relevant in the pathogenesis of symptoms. Methods: To assess the relationship between symptoms and weakly acidic, acid and mixed (liquid-gas) reflux, 24 h oesophageal pH-impedance monitoring was performed in 32 NERD and in 20 oesophagitis patients. In 12 NERD patients the study was repeated following 4 weeks treatment with a proton pump inhibitor (PPI). Impedance- pH data were compared with those of 10 asymptomatic controls. Heartburn and acid regurgitation were considered in the analysis of symptoms. Results: 15 NERD patients showed a physiological acid exposure time (pH-negative). Weakly acidic reflux was significantly less frequent in patients (25% (2%), mean (SE)) than in controls (54% (4%), p<0.01). Gas was present in 45-55% of reflux events in patient groups and controls, and decreased following PPI treatment. In NERD pH-negative patients, weakly acidic reflux accounted for 32% (10%) (vs 22% (6%) in NERD pH-positive and 12% (8%) in oesophagitis patients) and mixed reflux for more than two-thirds of all symptom-related refluxes. Multivariate logistic analysis showed that in NERD pH-negative patients, the risk of reflux perception was significantly higher when gas was present in the refluxate (odds ratio, 3.2; 95% CI, 1.2 to 10; p<0.01). Conclusions: The large majority of symptoms, in all patients, are related to acid reflux. In NERD patients, the presence of gas in the refluxate significantly enhances the probability of reflux perception. These patients are also more sensitive to less acidic reflux than oesophagitis patients.

ACCESSION #

31654665

 

Related Articles

• GERD BEYOND THE ESOPHAGUS. Magill-Lewis, Jillene // Drug Topics;4/15/2002, Vol. 146 Issue 8, p62 

  Provides information on the gastroesophageal reflux disease. Symptoms; Developments in drugs for treatment of the disease; Role of pharmacists in the treatment of the disease.

• hard to swallow. Drury, Kathryn // Vegetarian Times;Apr2001, Issue 284, p68 

  Focuses on gastroesophageal reflux disease (GERD), a condition characterized by frequent occurrence of heartburn. Pathophysiology; Causes; Foods that can help relieve the pain; Role of stress in increasing risks for GERD.

• Gastroesophageal Reflux in Children: When to be Concerned. Chitkara, Denesh; Martin, Nannette; Kelly, Maureen // Pediatrics for Parents;2006, Vol. 22 Issue 8, p7 

  The article talks about gastroesophageal reflux, the passage of stomach contents into the esophagus, which is a common problem in infants and children that typically occurs during or after a meal in 50 percent of newborns and up 67 percent of four month-old infants. The frequent episodes of...

• Whither surgery in the treatment of gastroesophageal reflux disease (GERD)?  // CMAJ: Canadian Medical Association Journal;1/20/2004, Vol. 170 Issue 2, p219 

  Provides information on gastroesophageal reflux disease (GERD), a risk factor for esophageal cancer. Drugs that are highly effective in the treatment of GERD; Example of surgical antireflux procedure for GERD; Important trends in therapeutic approaches to GERD.

• pH-impedance monitoring value in diagnosis of gastroesophageal reflux in children and teenagers - preliminary report. Szaflarska-Popławska, Anna; Mierzwa, Grażyna; Bała, Grażyna; Parzȩcka, Monika; Kuczyńska, Renata // Gastroenterologia Polska / Gastroenterology;2007, Vol. 14 Issue 4, p251 

  Aim of study: The aim of the study was assessment concerning pH-impedance usefulness in diagnostics of gastroesophageal reflux (GER) in children and teenagers. Material and methods: 53 children and teenagers were included into the study, aged from 7 to 18 years (the average age - 15 years),...

• Impact of gastroesophageal reflux disease on daily life: the Systematic Investigation of Gastrointestinal Diseases in China (SILC) epidemiological study. Rui Wang; Duowu Zou; Xiuqiang Ma; Zhao, Yanfang; Xiaoyan Yan; Hong Yan; Jiqian Fang; Ping Yin; Xiaoping Kang; Qiang Li; Dent, John; Sung, Joseph J.; Halling, Katarina; Johansson, Saga; Wenbin Liu; Jia He // Health & Quality of Life Outcomes;2010, Vol. 8, p128 

  Background: Gastroesophageal reflux disease imposes a significant burden of illness in Western populations. However, data on the impact of reflux symptoms on daily life in Asian populations are scarce. The current study aimed to evaluate the impact of GERD (defined on the basis of symptoms) on...

• Revised Criterion for Diagnosis of Ineffective Esophageal Motility Is Associated With More Frequent Dysphagia and Greater Bolus Transit Abnormalities. Blonski, Wojciech; Vela, Marcelo; Safder, Akber; Hila, Amine; Castell, Donald O. // American Journal of Gastroenterology;Mar2008, Vol. 103 Issue 3, p699 

  BACKGROUND: Ineffective esophageal motility (IEM) has been defined by the presence of ≥30% liquid swallows with contraction amplitude <30 mmHg (ineffective swallows) in the distal esophagus (“old” IEM). A recent study with combined multichannel intraluminal impedance and...

• Stress, GERD, Gastritis, Stomach And Duodenal Ulcers. Rosch, Paul J. // Health & Stress;Nov2007, Issue 11, p6 

  The article presents the stress-related disorders including gastroesophageal reflux disease (GERD), gastritis, stomach, and duodenal ulcers. According to the reports from the U.S., that there are more than 40 percent of adult citizens have these stress-related disorders. However, GERD is the...

• Gastroesophageal Reflux in the Older Child: Presentation, Response to Treatment and Long-Term Follow-Up. Treem, William R.; Davis, Patricia M.; Hyams, Jeffrey S. // Clinical Pediatrics;Jul1991, Vol. 30 Issue 7, p435 

  Much attention has been focused on the natural history of gastroesophageal reflux (GER) in neurologically normal infants which generally resolves by two years of age. In contrast, little is known of the outcome of GER diagnosed in normal older children. The charts of 32 children (21 males)...

Read the Article