Provocation of transient lower esophageal sphincter relaxations during continuous gastric distension.
BACKGROUND
Transient lower esophageal sphincter relaxations (TLESRs) are triggered by gastric distension. The aim of the study was to investigate TLESRs during controlled prolonged gastric distensions using the barostat technique.


METHODS
Twelve healthy volunteers (4 M, 8 F, age range 19-42 years) were studied under fasting conditions with combined esophageal manometry (Dentsleeve) and gastric barostat. Randomized isobaric distensions at 0 (control), 10, 12 and 14 mmHg were performed each period for 30 min with 30-min recovery periods in between.


RESULTS
The frequency of TLESR was significantly (P < 0.05) higher during all distension periods compared to control periods (4.0 +/- 0.4 TLESR/30 min versus 2.6 +/- 0.4 TLESR/30 min). The frequency of TLESR in the first 15-min period of distension was significantly (P < 0.001) higher compared to the second 15-min period pointing to adaptation (2.7 +/- 0.3 TLESR/15 min versus 1.3 +/- 0.2 TLESR/15 min, respectively). The frequency of TLESR correlated significantly with intragastric pressure (r = 0.47; P < 0.01) and wall tension (r = 0.48; P < 0.01), but not with intragastric volume. TLESR characteristics such as duration were not related to pressure or wall tension.


CONCLUSIONS
Acute gastric distension increases the frequency of TLESR but adaptation occurs rapidly. The frequency of TLESR during distension is related to pressure and wall tension rather than to intragastric volume.
Straathof
J W A
JW
Dept of Gastroenterology and Hepatology, Leiden University Medical Center, The Netherlands.
van Veen
M M
MM
Masclee
A A M
AA
D000328:Adult; D004943:Esophagogastric Junction / Q000503:physiopathology*; D005260:Female; D013271:Gastric Dilatation / Q000503:physiopathology*; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D007327:Insufflation; D008297:Male; D008365:Manometry; D008991:Monitoring, Physiologic; D009126:Muscle Relaxation / Q000502:physiology*; D011312:Pressure; D012016:Reference Values; D016037:Single-Blind Method; D013997:Time Factors