title: Postprandial proximal gastric acid pocket and gastroesophageal reflux disease.
abstract: An unbuffered layer of acidity that escapes neutralization by food has been demonstrated in volunteers and gastroesophageal reflux disease patients. This postprandial proximal gastric acid pocket (PPGAP) is manometrically defined by the presence of acid reading (pH<4) in a segment of the proximal stomach between nonacid segments distally (food) and proximally (lower esophageal sphincter or distal esophagus). The PPGAP may have important clinical implications; however, it is still poorly understood. Gastric anatomy and physiology seem to be important elements for PPGAP genesis. Gastric operations and acid suppression medications may decrease distal - proximal intragastric acid reflux and help control gastroesophageal reflux.
authors.affiliation: Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil. herbella.dcir@epm.br
authors.forename: F A M
authors.initials: FA
authors.lastname: Herbella
authors.forename: F P P
authors.initials: FP
authors.lastname: Vicentine
authors.forename: L C
authors.initials: LC
authors.lastname: Silva
authors.forename: M G
authors.initials: MG
authors.lastname: Patti
mesh_terms: D050782:Esophageal pH Monitoring; D005744:Gastric Acid / Q000502:physiology*; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000473:pathology / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D019518:Postprandial Period / Q000502:physiology*; D013270:Stomach / Q000473:pathology / Q000502:physiology