Composition of the postprandial refluxate in patients with gastroesophageal reflux disease.
OBJECTIVE
It is not known whether the characteristics of the postprandial refluxate in patients with gastroesophageal reflux disease (GERD) differ from those observed in normal subjects. The aim of this study was to characterize the postprandial refluxate in adult patients with GERD using combined intraluminal electrical impedance and pH measurements.


METHODS
Postprandial gastroesophageal reflux was assessed in 16 patients with GERD and 15 controls. pH and intraluminal electrical impedance were used to identify acid and nonacid reflux of liquid, mixed (liquid + gas) or gas.


RESULTS
Transient lower esophageal sphincter relaxations (TLESRs) and reflux of gastric contents were equally frequent in both groups. However, patients with GERD had more acid reflux [8 (4.7-10.5)/h vs 3.5 (2.6-6)/h, p < 0.05], and normal subjects had more nonacid reflux [5 (4.3-6.7)/h is 3 (1-3.5)/h, p < 0.05]. Gas reflux was less frequent in GERD than in controls (51% vs 68%; p < 0.05). Pure liquid reflux, however, was more frequent (40% vs 26%, p < 0.05) and twice as likely to be acid in GERD. During TLESRs, liquid acid reflux was more frequent in GERD than in controls.


CONCLUSIONS
TLESRs and reflux of gastric contents are similarly frequent in patients with GERD and controls. However, patients with GERD have more acid reflux and less nonacid reflux. Differences in the air-liquid composition of the refluxate may contribute to the higher rate of acid reflux observed in these patients.
Center for Gastroenterological Research, Catholic University of Leuven, Belgium.
D
D
Sifrim
R
R
Holloway
J
J
Silny
J
J
Tack
A
A
Lerut
J
J
Janssens
D000143:Acids / Q000378:metabolism; D000328:Adult; D000368:Aged; D017097:Electric Impedance; D004943:Esophagogastric Junction / Q000503:physiopathology; D005260:Female; D005740:Gases / Q000378:metabolism; D005764:Gastroesophageal Reflux / Q000378:metabolism / Q000503:physiopathology*; D006551:Hernia, Hiatal / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009126:Muscle Relaxation; D009130:Muscle, Smooth / Q000503:physiopathology; D019518:Postprandial Period; D012016:Reference Values; D012720:Severity of Illness Index; D013997:Time Factors
D000143:Acids; D005740:Gases