title: Residence of liquids in the infra-junctional portion of the proximal stomach in patients with gastroesophageal reflux disease.
abstract: Patients with gastroesophageal reflux disease may have disturbances of gastric motility, which could play a role in the pathophysiology of the disease. Recent studies have suggested that the gastric region just below the gastroesophageal junction may have a distinct physiological behavior. We determined whether patients with gastroesophageal reflux disease have abnormal residence of food in the infra-junctional portion of the stomach after ingesting a liquid nutrient meal. Fasted adult patients with reflux disease (N = 11) and healthy volunteers (N = 10) ingested a liquid meal (320 ml; 437 kcal) labeled with 99m technetium-phytate and their total gastric emptying half-time and regional emptying from the stomach infra-junctional region were determined. In 8 patients, episodes of postprandial acidic reflux to the esophagus were measured for 2 h using pH monitoring. There were no differences between reflux patients and controls regarding total gastric emptying time (median: 68 min; range: 39-123 min vs 65 min and 60-99 min, respectively; P > 0.50). Food residence in the infra-junctional area was similar for patients and controls: 23% (range: 20-30) vs 27% (range: 19-30%; P = 0.28) and emptying from this area paralleled total gastric emptying (Rs = 0.79; P = 0.04). There was no correlation between residence of food in the infra-junctional area and episodes of gastroesophageal reflux (Rs = 0.06; P = 0.88). We conclude that it is unlikely that regional motor disturbances involving the infra-junctional region of the stomach play a relevant role in the pathogenesis of acidic gastroesophageal reflux.
authors.affiliation: Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: C L A
authors.initials: CL
authors.lastname: Barbieri
authors.forename: L E A
authors.initials: LE
authors.lastname: Troncon
authors.forename: J R L
authors.initials: JR
authors.lastname: Herculano
authors.forename: L R O
authors.initials: LR
authors.lastname: Aprile
authors.forename: R O
authors.initials: RO
authors.lastname: Dantas
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004943:Esophagogastric Junction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010833:Phytic Acid; D011877:Radionuclide Imaging; D013997:Time Factors
chemical_list: D015609:Organotechnetium Compounds; C026177:technetium phytate; D010833:Phytic Acid