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. 2000 Nov;47(5):661–666. doi: 10.1136/gut.47.5.661

Gastric emptying: a contributory factor in gastro-oesophageal reflux activity?

G Stacher 1, J Lenglinger 1, H Bergmann 1, C Schneider 1, M Hoffmann 1, G Wolfl 1, G Stacher-Janotta 1
PMCID: PMC1728126  PMID: 11034582

Abstract

AIMS—To evaluate the impact of total and proximal stomach emptying on 24 hour and postprandial reflux as well as the number of reflux episodes per hour in relation to the impact of lower oesophageal sphincter (LOS) pressure, and oesophageal contractile and clearance function.
METHODS—Seventy one outpatients (37 female, 34 male; age 23-82 years) with symptoms suggestive of both delayed gastric emptying and reflux referred for further investigations participated in the study. Gastric emptying of a semisolid 1168 kJ meal and oesophageal clearance of a water bolus (supine) were recorded scintigraphically, reflux by 24 hour pH monitoring, and oesophageal motility manometrically.
RESULTS—Slow proximal but not slow distal or total stomach emptying correlated with increased 24 hour and postprandial acid exposure and increased number of reflux episodes/hour. No relationship was found between total or proximal emptying and LOS resting pressure, oesophageal contraction amplitude, percentage of failed contractions, or clearance. Multiple linear regression analyses showed that slow proximal emptying and low LOS pressure contributed significantly to both 24 hour (p=0.0007 and p=0.0001) and two hour postprandial acid exposure (p=0.007 and p=0.0001). In contrast, the rate of total emptying contributed to neither 24 hour nor postprandial acid exposure.
CONCLUSION—Our data suggest that in contrast with total stomach emptying, the rate of proximal stomach emptying contributes to the extent of 24 hour as well as postprandial acid exposure and the number of reflux episodes/hour.


Keywords: gastro-oesophageal reflux; gastric emptying; proximal stomach; lower oesophageal sphincter; oesophageal motor activity; oesophageal clearance

Full Text

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Figure 1  .

Figure 1  

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Relationship between proximal stomach emptying (AUCprox) and percentage of time spent with pH <4 in the 24 hour recording period (24 hour acid exposure) on a logarithmic scale.

Figure 2  .

Figure 2  

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Relationship between proximal stomach emptying (AUCprox) and percentage of time spent with pH <4 in the postprandial two hour period (postprandial acid exposure) on a logarithmic scale.

Figure 3  .

Figure 3  

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Relationship between total stomach emptying (AUCtot) and percentage of time spent with pH <4 in the 24 hour recording period (24 hour acid exposure) on a logarithmic scale.

Figure 4  .

Figure 4  

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Relationship between total stomach emptying (AUCtot) and percentage of time spent with pH <4 in the postprandial two hour period (postprandial acid exposure) on a logarithmic scale.

Figure 5  .

Figure 5  

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Relationship between lower oesophageal sphincter (LOS) resting pressure and percentage of time spent with pH <4 in the 24 hour recording period (24 hour acid exposure) on a logarithmic scale.

Figure 6  .

Figure 6  

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Relationship between lower oesophageal sphincter (LOS) resting pressure and percentage of time spent with pH <4 in the postprandial two hour period (postprandial acid exposure) on a logarithmic scale.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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