[The effect of lumbar relief orthoses with abdominal compression on esophago-gastrointestinal motility].
OBJECTIVE
To investigate the effect of lumbar ortheses with abdominal compression on gastro-oesophageal reflux and gastrointestinal transit.


METHODS
In a prospective study 20 consecutive patients with lumbar syndrome treated with lumbar orthesis (10 female, 10 male, median age 54.6 years) were investigated for gastro-oesophageal reflux, mouth-to-cecum transit time (MCT), and whole-gut transit time. Gastro-oesophageal reflux was assessed performing an ambulatory pH metering of the distal oesophagus over a period of 10 h with and without ortheses on two separate study days. After positioning of the pH catheter patients ingested a liquid-solid test meal labelled with 10 g lactulose and 750 g indigocarmine to determine MCT with the hydrogen breath test and whole-gut transit by the first appearance of indigocarmine in the stool. Dyspepsia was assessed by using a standardized questionnaire.


RESULTS
Lumbar ortheses induced a significant increase in reflux time (pH < 4) (8.1 vs 4.1%), total number of reflux episodes (102.5 vs 69.5) and duration of longest reflux episode (6.0 vs 3.7 min) (P < 0.05). 12 patients with ortheses revealed an increase in relative reflux time (2.1-24.5%, median: 8.2%) more than two standard deviations compared to previously obtained normal values. In these patients during ortheses dyspeptic symptoms correlated significantly with reflux time (r = 0.6; P < 0.05). In contrast, MCT and whole-gut transit time in patients with and without ortheses did not differ significantly (85 vs 85 min; 10.2 vs 9.6 h).


CONCLUSIONS
Lumbar ortheses with abdominal compression, nowadays frequently used in the lumbar syndrome, produce gastro-oesophageal reflux associated with dyspepsia. Gastrointestinal transit time is not affected, though.
Pfaffenbach
B
B
Medizinische Universitätsklinik, St. Josef-Hospital, Ruhr-Universität Bochum.
Adamek
R J
RJ
Schleyer
S
S
Grifka
J
J
Wegener
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D004396:Coloring Agents / Q000737:chemistry; D004947:Esophagus / Q000737:chemistry; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology*; D005765:Gastrointestinal Agents / Q000737:chemistry; D005769:Gastrointestinal Motility; D005772:Gastrointestinal Transit; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D006863:Hydrogen-Ion Concentration; D007203:Indigo Carmine / Q000737:chemistry; D007792:Lactulose / Q000737:chemistry; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices / Q000009:adverse effects*; D011312:Pressure; D011446:Prospective Studies
D004396:Coloring Agents; D005765:Gastrointestinal Agents; D007792:Lactulose; D006859:Hydrogen; D007203:Indigo Carmine