Kinetics of transient hiatus hernia during transient lower esophageal sphincter relaxations and swallows in healthy subjects

摘要: Background Proximal displacement of the gastro-esophageal junction (GEJ) is present in hiatus hernia but also occurs transiently during transient lower esophageal sphincter relaxations (TLESRs) and swallows. Using a novel magnetic-based technique we have performed detailed examination GEJ movement TLESRs swallows healthy subjects. Methods In 12 subjects, magnet was endoscopically clipped to combined assembly Hall-Effect locator probe 36 channel high-resolution manometer passed nasally. After test meal subjects were studied for 90 min. Key Results The median amplitude proximal 4.3 cm (1.68.8 cm) this substantially greater than swallowing at 1.2 (0.42.7 cm), P = 0.002. With both coincided with (LES) relaxation return its original position occurred 4 s after LES tone. Kinetic modeling indicated two phases initial phase having velocity (0.9 s-1) being strongly correlated (r 0.8, < 0.001). Conclusions & Inferences marked migration represents very severe herniation GEJ. rapid following when crural diaphragm relaxed correlation suggest it due elastic recoil phreno-esophageal ligament. stretching ligament may contribute weakening development established hernia.