OBJECTIVES: Physical exercise has become popular in recent years. It has been known that exercise is related to the development of heartburn, belching, regurgitation and chest pain. However there are few data concerning the effect of exercise on esophageal motor function and gastroesophageal reflux. We evaluated the effect of exercise intensity on esophageal motor activity and gastroesophageal reflux. METHODS: We studied healthy volunteers (15 males, age: 28+/-5 years, BW: 68+/-10kg) using a 24 hours ambulatory esophageal pressure, pH catheter and portable digital data recorder (Microdigitrapper 4Mb, Synetics Medical, Sweden). Subjects exercised on a treadmill (Marquette Case 15 Electronic INC) at 50% and 70% maximal heart rate for 30 min. Subjects rested 2 hours before exercise (base line) and for 30 min between exercise sessions. RESULTS: 1) Exercise of 50% maximal heart rate reduced total contraction, contraction duration, percentage of simultaneous contraction and repetitive contraction, (P<0.05) but increased percentage of contractions above 20mmHg amplitude (P<0.05). 2) Exercise of 70% maximal heart rate decreased total contraction, esophageal amplitude, contraction duration and percentage of peristaltic contraction, (P<0.05) but increased percentage of simultaneous contraction (P<0.05). 3) Gastroesophageal reflux was not change on both 50% maximal heart rate and 70% maximal heart rate exercise. CONCLUSION: More propulsive esophageal motility are induced following exercise of 50% maximal heart rate, but not 70% maximal heart rate.
Catheters ; Chest Pain ; Eructation ; Exercise ; Gastroesophageal Reflux* ; Healthy Volunteers ; Heart Rate ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Male ; Motor Activity ; Running*

The routine of endoscopy in the evaluatien of gastrointestinal bleeding demonatratd that telangiectasia in the upper gastrointestinal tract may be responsible for the chronic recurrent bleeding. If the bleeding lesion within the reach of the endoscaiye, it is amenahle to endoscopic therapy, One of the several treatment modalities that has been employed is laser photocoagulation. We report a case of ef fective laser therapy in a 63-years old woman presented with a about 3 years history of recurrent upper gastrointestinal bleeding and persistent iron deficieney anemia in gaatic multiple telangeictasias. An upper gastrointestinal endoscopy demonstrated variable sized multiple bleeding telangectatic lesions in the entire stomach. Nd-YAG laser photocoagulation was appligd in 0.5 seconds pulse of 60-70W power(2300 joules and total 7 sessions). All legions in the stomach were treated. Local epinephrine injection prior to laser treatment was carried out in the telangiectatie lesions greater than 1 cm. Follow-up endoscopy 5 months after laser treatment demonstrated no telangiectatic lesions in the stomach and no episodes of upper gastrointestinal bleeding were noted and the other symptoms improved.
Anemia ; Endoscopy ; Endoscopy, Gastrointestinal ; Epinephrine ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Iron ; Laser Therapy ; Lasers, Solid-State ; Light Coagulation* ; Middle Aged ; Stomach ; Telangiectasis* ; Upper Gastrointestinal Tract

The routine of endoscopy in the evaluatien of gastrointestinal bleeding demonatratd that telangiectasia in the upper gastrointestinal tract may be responsible for the chronic recurrent bleeding. If the bleeding lesion within the reach of the endoscaiye, it is amenahle to endoscopic therapy, One of the several treatment modalities that has been employed is laser photocoagulation. We report a case of ef fective laser therapy in a 63-years old woman presented with a about 3 years history of recurrent upper gastrointestinal bleeding and persistent iron deficieney anemia in gaatic multiple telangeictasias. An upper gastrointestinal endoscopy demonstrated variable sized multiple bleeding telangectatic lesions in the entire stomach. Nd-YAG laser photocoagulation was appligd in 0.5 seconds pulse of 60-70W power(2300 joules and total 7 sessions). All legions in the stomach were treated. Local epinephrine injection prior to laser treatment was carried out in the telangiectatie lesions greater than 1 cm. Follow-up endoscopy 5 months after laser treatment demonstrated no telangiectatic lesions in the stomach and no episodes of upper gastrointestinal bleeding were noted and the other symptoms improved.
Anemia ; Endoscopy ; Endoscopy, Gastrointestinal ; Epinephrine ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Iron ; Laser Therapy ; Lasers, Solid-State ; Light Coagulation* ; Middle Aged ; Stomach ; Telangiectasis* ; Upper Gastrointestinal Tract

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

The prevalence of gastroesophageal reflux disease (GERD) in Western countries ranges between 10% and 20%. Although GERD is increasing in Korea, it is difficult to actively conduct studies due to restrictions in insurance regulations and there are practical limitations to prescribe drugs conforming the evidence-based guidelines. As novel drug therapy for GERD, drugs with new mechanisms that would overcome pharmacokinetic limits of proton pump inhibitors are being investigated. In this review, with regards to drug therapy of GERD, we discuss management strategies suitable for domestic circumstances and drugs that are being newly developed.
Gastroesophageal Reflux ; Insurance ; Korea ; Prevalence ; Proton Pump Inhibitors ; Social Control, Formal

No abstract availble.
Aged ; Chronic Disease ; Colonoscopy ; *Enema ; Female ; Humans ; Proctitis/*drug therapy/pathology ; Radiation Injuries/*drug therapy/pathology ; Sucralfate/*administration & dosage

No abstract available.

BACKGROUND/AIMS: Ischemic colitis is a vascular condition of inadequate blood flow in the colon which leads to colonic inflammation and can cause significant morbidity and mortality. Oxidative stress is an early initiating event in ischemia and reperfusion injury. Heme oxygenase (HO) is considered to be an antioxidant enzyme that catabolizes heme to carbon monoxide, free iron and biliverdin. The aim of this study was to evaluate the expression patterns of HO-1, inducible form of HO, in ischemic colitis. METHODS: We analyzed the twelve cases of clinically and pathologically diagnosed ischemic colitis without surgical intervention compared with normal colon (n=10) and psedomembranous colitis (n=5). Immunohistochemical stainings for HO-1 were performed in paraffin-embedded tissues. RESULTS: The age of the patients ranged from 56 to 84 years (mean: 67 years) in ischemic colitis. Eight patients (66.7%) were female. The most common presenting symptom was bloody stool (66.7%) and rectosigmoid area (91.7%) of the large intestine was the most common ischemic site. Expression of HO-1 in ischemic colitis was high in contrast to normal colonic mucosa or psedomembranous colitis. CONCLUSIONS: Ischemic colitis usually involves the rectosigmoid area in elderly female patients with a history of bloody stool. High expression of HO-1 in ischemic colitis may be responsible for a protective mechanism to ischemia or heme injury.
Aged ; Aged, 80 and over ; Colitis, Ischemic/*enzymology ; Colon/*enzymology ; Female ; Heme Oxygenase (Decyclizing)/*metabolism ; Humans ; Immunohistochemistry ; Intestinal Mucosa/*enzymology ; Male ; Middle Aged

No abstract available
Colonic Neoplasms/complications/*pathology ; Colonic Polyps/complications/*pathology/surgery ; *Colonoscopy ; Gastrointestinal Hemorrhage/*etiology ; Hemangioma, Cavernous/complications/*pathology ; Humans ; Male ; Middle Aged