The effects of different grades of running on esophageal motility and gastroesophageal reflux in the fed state were evaluated. We studied healthy volunteers (male: 12, age: 27+/-5 yr) using ambulatory esophageal manometry, pH catheter and portable digital data recorder. Each exercise was performed 30 min after meal, with 20 min of rest between exercises. Subjects exercised on a treadmill at 40% and 70% maximal heart rate. The number of gastroesophageal reflux episodes, the duration of esophageal acid exposure and percent time pH below 4 were significantly (p<0.01) increased during exercise at 70% maximal heart rate. The frequency of contraction (contraction/min) (p<0.05), frequency of repetition (p<0.01), percent of simultaneous contraction (p<0.01), percent of above 100 mmHg amplitude (p<0.05), and frequency of 2-peak contraction (p<0.01) were significantly increased during exercise at 70% maximal heart rate. However, median amplitude and median duration showed no significant changes between each exercise session. Postprandial running exercises induce gastroesophageal reflux, which correlates with exercise intensity. These effects are mediated by disorganized esophageal motility.
Adult ; *Eating ; Esophageal Motility Disorders/etiology/*physiopathology ; Gastroesophageal Reflux/etiology/*physiopathology ; Human ; Male ; Postprandial Period ; *Running

To determine the relationship between Barrett's esophagus (BE) and features of gastroesophageal acid reflux, 24 h esophageal pH monitoring was performed in 90 patients. The patients were divided into 3 groups: 31 subjects with BE, 21 with mild esophagitis and 38 with severe esophagitis. The following parameters were evaluated: the percentage time of pH < 4; the number of reflux episodes over 5 min; the duration of longest episodes and DeMeester score over total period and the auterior three parameters in erect and supine position. All these parameters in BE were significantly different from those with mild esophagitis (P < 0.01) and not significantly different from those with severe esophagitis (P > 0.05). During supine position all the above parameters in BE were significantly different from those with reflux esophagitis (P < 0.05). It is concluded that the quantity of acid reflux is not an important factor in development of BE in gastroesophageal reflux (GER), and the acid reflux in supine position might be important in development of BE in GER.
Barrett Esophagus/etiology ; Barrett Esophagus/*physiopathology ; Esophagitis, Peptic/etiology ; Gastroesophageal Reflux/*complications ; Hydrogen-Ion Concentration ; Supine Position

BACKGROUNDSymptoms, endoscopy, and pH monitoring form the basis of diagnosis of gastroesophageal reflux disease (GERD). Their relationship was meaningful for primary care physicians, but still unclear. Our research aimed to compare questionnaire, endoscopy, and pH monitoring and to analyze their correlations.

METHODSThree hundred patients who underwent the Reflux Disease Questionnaire (RDQ), endoscopy, and esophageal 24-hour pH monitoring from March 2007 to December 2010 in Peking University People's Hospital were enrolled. We analyzed the characteristics of different investigations and their relationships.

RESULTSMale (OR for mild reflux esophagitis (RE) = 2.433, severe RE = 8.386), body mass index (BMI) (OR for mild RE = 1.222, severe RE = 1.297), and hernia (OR for mild RE = 6.059, severe RE = 17.547), were found to be the risk factors for RE; age (OR = 1.074) was correlated with severe RE. The consistency of questionnaire, endoscopy, and pH monitoring was poor: RDQ did not agree well with pH monitoring (κ = 0.061), nor with endoscopy (κ = 0.044); pH monitoring did not agree well with endoscopy (κ = 0.316). However, the severity of mucosa injury in RE was associated with pathological acid exposure (PAE): reflux episodes of >5 minutes (P = 0.035), the percentage time pH <4 (P = 0.017), and the DeMeester score (P = 0.016) increased significantly in patients with severe RE. Chest pain had poor relationship with RE or PAE.

CONCLUSIONSMale, age, BMI, and hernia were probably risk factors for esophagitis. RDQ, endoscopy, and pH monitoring have their own focus and reinforce each other in diagnosis. Of the GERD symptoms, chest pain had negative correlation with RE or PAE.

Adult ; Aged ; Body Mass Index ; Esophageal pH Monitoring ; Esophagitis ; etiology ; pathology ; physiopathology ; Female ; Gastroesophageal Reflux ; complications ; pathology ; physiopathology ; Hernia ; complications ; pathology ; physiopathology ; Humans ; Male ; Middle Aged ; Risk Factors

To determine the relationship between Barrett's esophagus (BE) and features of gastroesophageal acid reflux, 24 h esophageal pH monitoring was performed in 90 patients. The patients were divided into 3 groups: 31 subjects with BE, 21 with mild esophagitis and 38 with severe esophagitis. The following parameters were evaluated: the percentage time of pH < 4; the number of reflux episodes over 5 min; the duration of longest episodes and DeMeester score over total period and the auterior three parameters in erect and supine position. All these parameters in BE were significantly different from those with mild esophagitis (P < 0.01) and not significantly different from those with severe esophagitis (P > 0.05). During supine position all the above parameters in BE were significantly different from those with reflux esophagitis (P < 0.05). It is concluded that the quantity of acid reflux is not an important factor in development of BE in gastroesophageal reflux (GER), and the acid reflux in supine position might be important in development of BE in GER.
Adult ; Barrett Esophagus ; etiology ; physiopathology ; Esophagitis, Peptic ; etiology ; Female ; Gastroesophageal Reflux ; complications ; Humans ; Hydrogen-Ion Concentration ; Male ; Middle Aged ; Supine Position

Child ; Chronic Disease ; Cough ; classification ; diagnosis ; drug therapy ; epidemiology ; physiopathology ; Environment ; Fraxinus ; Gastroesophageal Reflux ; etiology ; Humans ; Molecular Diagnostic Techniques ; methods ; Parenting ; psychology ; Psychology, Child

Aged ; Animals ; Asphyxia ; etiology ; Asthma ; physiopathology ; Catheter Ablation ; Female ; Fundoplication ; Gastroesophageal Reflux ; complications ; surgery ; Humans ; Laryngismus ; etiology ; Male ; Middle Aged ; Rats ; Rats, Sprague-Dawley ; Respiration Disorders ; etiology ; physiopathology ; Treatment Outcome

Child ; Chronic Disease ; Cough ; etiology ; therapy ; Diagnosis, Differential ; Esophageal pH Monitoring ; Esophagus ; pathology ; physiopathology ; Gastroesophageal Reflux ; complications ; diagnosis ; therapy ; Humans ; Infant ; Monitoring, Physiologic ; Respiratory Hypersensitivity ; etiology ; therapy ; Stomach ; pathology ; physiopathology

Achalasia is an esophageal motility disorder that is commonly misdiagnosed initially as gastroesophageal reflux disease. Patients with achalasia often complain of dysphagia with solids and liquids but may focus on regurgitation as the primary symptom, leading to initial misdiagnosis. Diagnostic tests for achalasia include esophageal motility testing, esophagogastroduodenoscopy and barium swallow. These tests play a complimentary role in establishing the diagnosis of suspected achalasia. High-resolution manometry has now identified three subtypes of achalasia, with therapeutic implications. Pneumatic dilation and surgical myotomy are the only definitive treatment options for patients with achalasia who can undergo surgery. Botulinum toxin injection into the lower esophageal sphincter should be reserved for those who cannot undergo definitive therapy. Close follow-up is paramount because many patients will have a recurrence of symptoms and require repeat treatment.
Botulinum Toxins/administration & dosage ; Deglutition Disorders/etiology ; Diagnostic Errors ; Endoscopy, Digestive System ; Esophageal Achalasia/*diagnosis/etiology/physiopathology/therapy ; Esophageal Sphincter, Lower ; Esophagus/physiopathology/surgery ; Gastroesophageal Reflux/diagnosis ; Humans ; Injections, Subcutaneous ; Manometry ; Neurotransmitter Agents/administration & dosage ; Recurrence

OBJECTIVETo investigate the effects of standard meal and fat meal distending the fundus on transient lower esophageal sphincter relaxation (TLESR) and esophageal motility and to explore the mechanism of gastroesophageal reflux (GER) in patients with gastroesophageal reflux disease (GERD).

METHODSEight patients with GERD (3 male, 5 female; median age: 43.5 ys) were enrolled in the study. All received 2 times of esophageal manometry and pH monitoring simultaneously for 30 min during fasting and 2 h after two different test-meals, including standard meal (SM) and fat meal (FM) on separate day at least 1 week apart.

RESULTSThe frequency of TLESR significantly increased after 2 test-meals (P < 0.05). There were no significant difference in the frequency and duration of TLESR between SM group and FM group 1 h after meal (P > 0.05). However, the frequency of TLESR in FM group 2 h after meal was more than that in SM group and during fasting (P < 0.05). Lower esophageal sphincter pressure (LESP) significantly decreased in FM group than in SM group (P < 0.05). The contractive amplitude of post lower esophageal sphincter relaxation and the contractive amplitude of the distal esophagus had no difference after FM and SM. Acid reflux episodes and duration of pH < 4 were larger after FM than after SM (P < 0.05). A total of 50.2% of GER occurred during decreased LESP and 37.8% during TLESR after FM, while 61.7% of GER occurred during TLESR after SM.

CONCLUSIONSBoth the SM and FM can increase the frequency of TLESR in patients with GERD. Decreased LESP and increased frequency of TLESR after FM are the major mechanism of GER, while reflux after SM may attribute to the increased frequency of TLESR.

Adult ; Dietary Fats ; administration & dosage ; Energy Intake ; Esophageal Sphincter, Lower ; physiopathology ; Esophagus ; physiopathology ; Female ; Gastroesophageal Reflux ; etiology ; physiopathology ; Humans ; Hydrogen-Ion Concentration ; Male ; Manometry ; Middle Aged ; Muscle Relaxation ; Pressure

OBJECTIVETo observe the therapeutic effect of modified Zhizhu pill (ZZP) in treating gastro-esophageal reflux disease (GERD) and to explore its mechanism.

METHODSSixty-three GERD patients were randomly divided into the treated group (n = 30) and the control group (n = 33). The treated group was treated with ZZP 100 ml, twice daily by orally taking half an hour before meal. The control group was treated with Ranitidine 0.15 g, twice daily and Cisapride 10 mg, three times a day by orally taking before meal. The therapeutic course for both groups was 8 weeks. The changes of symptom scoring, endoscopic examination, esophageal pressure, 24 hrs monitoring on pH and blood level of motilin in the two groups were recorded and compared.

RESULTSAfter treatment, the symptom scoring, esophageal pressure, 24 hrs monitoring on pH and blood motilin level were improved in both groups (P < 0.05), and the improvement in the treated group was more significant than that in the control group (P < 0.05).

CONCLUSIONZZP has good effect in treating GERD.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Esophagitis ; drug therapy ; etiology ; Esophagus ; physiopathology ; Female ; Gastroesophageal Reflux ; complications ; drug therapy ; Humans ; Hydrogen-Ion Concentration ; Male ; Manometry ; Middle Aged ; Monitoring, Physiologic ; Motilin ; blood ; Phytotherapy ; Ranitidine ; therapeutic use