title: Evidence for the ''paradox'' association between hypertensive lower esophageal sphincter and gastroesophageal reflux disease.
abstract: There are several studies suggesting the paradoxical simultaneous presence of hypertensive lower oesophageal sphincter and gastroesophageal reflux disease. We present a case of a 22-year-old male patient who was examined in our outpatient clinic with oesophageal food bolus impaction during a meal, severe chest pain and drooling. Manometry revealed a hypertensive lower esophageal sphincter pressure (resting pressure 35 mmHg) and pHmetry revealed a DeMeester score > 14.72 (43.27). Six months after therapy with lansoprazole, manometry revealed a normal lower oesophageal sphincter (resting pressure 14 mmHg) and the DeMeester score was < 14.72 (5.89). The patient is now asymptomatic. This report is the only published case which exhibits the normalization of lower oesophageal pressure 6 months after gastroesophageal reflux disease management with lansoprazole, thus proving and establishing the above ''paradox''.
authors.affiliation: Medical School, Democritus University of Thrace Alexandroupolis, Greece. gtagarakis@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Kouklakis
authors.forename: J
authors.initials: J
authors.lastname: Moschos
authors.forename: D
authors.initials: D
authors.lastname: Paikos
authors.forename: G
authors.initials: G
authors.lastname: Tagarakis
authors.forename: E
authors.initials: E
authors.lastname: Rouska
authors.forename: A
authors.initials: A
authors.lastname: Mpoumponaris
authors.forename: N
authors.initials: N
authors.lastname: Lyrantzopoulos
authors.forename: E
authors.initials: E
authors.lastname: Molyvas
authors.forename: G
authors.initials: G
authors.lastname: Minopoulos
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000328:Adult; D000787:Angina Pectoris / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008365:Manometry; D011312:Pressure
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D064747:Lansoprazole