Patterns of gastroesophageal reflux in health and disease.

摘要: Twenty-four pH monitoring the distal esophagus quantitates gastroesophageal reflux in a near physiologic setting by measuring frequency and duration of acid exposure to esophageal mucosa. Fifteen asymptomatic volunteers were studies with 24-hour manometry. The normal cardia was more competent supine than upright position. Physiologic unaffected age, rarely occurred during slumber, rule after alimentation. One hundred symptomatic pateitns an abnormal record (2 S.D. above mean controls) could be divided into three patterns pathological reflux: those who refluxed only position (9), (37), both positions (54). Upright differed from refluxers excessive aerophagia causing episodes repetitive belching. Compared controls, they had post-prandial reflux, lower DES pressure, less exposed positive pressure abdomen. Supine having higher incidence esophagitis inability clear episode. pressure. Combined refluxers. Stricture (15%) seen this group. They similar their Forty 100 patients antireflux procedure (4 upright, 8 supine, 28 combined). most severe postoperative flatus abdominal distention It is concluded that minimal physiological. Patients all have environment are prone develop esophagitis. disease at risk developing strictures. In delayed gastric emptying may important etiological factor.