Abstract
Intraluminal manometric studies were carried out in 19 patients with untreated achalasia and in 20 normals. Lower esophageal sphincter (LES) pressure was 50.5 ±4.6 mm Hg in patients with achalasia as compared with 19.4 ±1.3 mm Hg in the normal group. In both groups, the LES pressure was lowered when exogenous 0.1 N HCl was placed into the stomach. Although the nadir of pressure attained with acid suppression was the same, the per cent inhibition was significantly greater in patients with achalasia. Serum gastrin levels were the same in the two groups studied. The patients with achalasia, pre- and postpneumatic dilatation, showed a supersensitivity to exogenous intravenous gastrin I, as compared with normals. These data suggest that high, acid-suppressible levels of LES pressure, in patients with achalasia, are due to supersensitivity to endogenous gastrin.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- ANDERSSON S., OLBE L. INHIBITION OF GASTRIC ACID RESPONSE TO SHAM FEEDING IN PAVLOV POUCH DOGS BY ACIDIFICATION OF ANTRUM. Acta Physiol Scand. 1964 May-Jun;61:55–64. doi: 10.1111/j.1748-1716.1964.tb02942.x. [DOI] [PubMed] [Google Scholar]
- Bennett A. Effect of gastrin on isolated smooth muscle preparation. Nature. 1965 Oct 9;208(5006):170–173. doi: 10.1038/208170a0. [DOI] [PubMed] [Google Scholar]
- CASSELLA R. R., BROWN A. L., Jr, SAYRE G. P., ELLIS F. H., Jr ACHALASIA OF THE ESOPHAGUS: PATHOLOGIC AND ETIOLOGIC CONSIDERATIONS. Ann Surg. 1964 Sep;160:474–487. doi: 10.1097/00000658-196409000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- CREAMER B., OLSEN A. M., CODE C. F. The esophageal sphincters in achalasia of the cardia (cardiospasm). Gastroenterology. 1957 Aug;33(2):293–301. [PubMed] [Google Scholar]
- Castell D. O., Harris L. D. Hormonal control of gastroesophageal-sphincter strength. N Engl J Med. 1970 Apr 16;282(16):886–889. doi: 10.1056/NEJM197004162821602. [DOI] [PubMed] [Google Scholar]
- Cohen S., Harris L. D. Lower esophageal sphincter pressure as an index of lower esophageal sphincter strength. Gastroenterology. 1970 Feb;58(2):157–162. [PubMed] [Google Scholar]
- Cohen S., Lipshutz W. Hormonal regulation of human lower esophageal sphincter competence: interaction of gastrin and secretin. J Clin Invest. 1971 Feb;50(2):449–454. doi: 10.1172/JCI106512. [DOI] [PMC free article] [PubMed] [Google Scholar]
- HARRIS L. D., POPE C. E., 2nd "SQUEEZE" VS. RESISTANCE: AN EVALUATION OF THE MECHANISM OF SPHINCTER COMPETENCE. J Clin Invest. 1964 Dec;43:2272–2278. doi: 10.1172/JCI105101. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KRAMER P., INGELFINGER F. J. Esophageal sensitivity to mecholyl in cardiospasm. Gastroenterology. 1951 Oct;19(2):242–253. [PubMed] [Google Scholar]
- McGuigan J. E. Antibodies to the carboxyl-terminal tetrapeptide of gastrin. Gastroenterology. 1967 Nov;53(5):697–705. [PubMed] [Google Scholar]
- McGuigan J. E. Immunochemical studies with synthetic human gastrin. Gastroenterology. 1968 Jun;54(6):1005–1011. [PubMed] [Google Scholar]
- McGuigan J. E., Trudeau W. L. Studies with antibodies to gastrin. Radioimmunoassay in human serum and physiological studies. Gastroenterology. 1970 Feb;58(2):139–150. [PubMed] [Google Scholar]
- Misiewicz J. J., Waller S. L., Anthony P. P., Gummer J. W. Achalasia of the cardia: pharmacology and histopathology of isolated cardiac sphincteric muscle from patients with and without achalasia. Q J Med. 1969 Jan;38(149):17–30. [PubMed] [Google Scholar]
- Pope C. E., 2nd A dynamic test of sphincter strength: its application to the lower esophageal sphincter. Gastroenterology. 1967 May;52(5):779–786. [PubMed] [Google Scholar]
- Pope C. E., 2nd The esophagus: 1967 to 1969. I. Gastroenterology. 1970 Sep;59(3):460–476. [PubMed] [Google Scholar]
- TROUNCE J. R., DEUCHAR D. C., KAUNTZE R., THOMAS G. A. Studies in achalasia of the cardia. Q J Med. 1957 Oct;26(104):433–443. [PubMed] [Google Scholar]
- Trendelenburg U. Mechanisms of supersensitivity and subsensitivity to sympathomimetic amines. Pharmacol Rev. 1966 Mar;18(1):629–640. [PubMed] [Google Scholar]
- VANTRAPPEN G., VANGOIDSENHOVEN G. E., VERBEKE S., VANDENBERGHE G., VANDERBROUCKE J. MANOMETRIC STUDIES IN ACHALASIA OF THE CARDIA, BEFORE AND AFTER PNEUMATIC DILATIONS. Gastroenterology. 1963 Sep;45:317–325. [PubMed] [Google Scholar]
- Winans C. S., Harris L. D. Quantitation of lower esophageal sphincter competence. Gastroenterology. 1967 May;52(5):773–778. [PubMed] [Google Scholar]
- Yalow R. S., Berson S. A. Radioimmunoassay of gastrin. Gastroenterology. 1970 Jan;58(1):1–14. [PubMed] [Google Scholar]