Reduction of abdominal pressure in patients with ascites reduces gastroesophageal reflux.
The effect of the reduction of intra-abdominal pressure on the lower esophageal sphincter pressure (LESP) and the 24-hour pH monitoring were studied in 16 patients with ascites before and after paracentesis. LESP did not change (P > 0.05) with the reduction of intra-abdominal pressure (before paracentesis: 17.48 mmHg and postparacentesis: 18.67 mmHg). The results were divided into two groups according to the achieved reduction in intra-abdominal pressure group A were those in who the reduction was greater than 70% and B consisted of those a reduction of less than 70%. LESP did not change even when results for each group were considered separately (P > 0.05): group A (before: 15.60 mmHg; after: 18.09 mmHg); group B (before: 23.09 mmHg; after: 20.40 mmHg). However the 24-h pH monitoring showed pathological reflux in patients with ascites that was reduced with the paracentesis (P < 0.05; total number of reflux episodes before paracentesis was 520.26, and after, 136.26). All pH-monitoring parameters were statistically different (P < 0.05) before and after the reduction of intra-abdominal pressure for group A but not for group B. LESP does not change significantly (P > 0.05) when the intra-abdominal pressure is significantly reduced (P < 0.05). Patients with ascites showed gastroesophageal reflux. Intra-abdominal pressure reduction greater than 70% lead to a significant reduction in gastroesophageal reflux.
Navarro-Rodriguez
T
T
Department of Gastroenterology, Faculty of Medicine, University of São Paulo, Brazil.
Hashimoto
C L
CL
Carrilho
F J
FJ
Strauss
E
E
Laudanna
A A
AA
Moraes-Filho
J P P
JP
D000005:Abdomen / Q000502:physiology*; D001201:Ascites / Q000503:physiopathology*; D016022:Case-Control Studies; D004943:Esophagogastric Junction / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000517:prevention & control*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008107:Liver Diseases / Q000503:physiopathology; D008991:Monitoring, Physiologic; D019152:Paracentesis; D011312:Pressure; D011446:Prospective Studies