PMID: 11903733Mar 21, 2002Paper

Upright versus supine reflux in gastroesophageal reflux disease

Journal of Gastroenterology and Hepatology
R Ouatu-LascarG Triadafilopoulos

Abstract

Postural measures are early recommendations in the management of heartburn, and are aimed at preventing acid reflux through an incompetent lower esophageal sphincter (LES). However, LES incompetence is found in only a minority of patients, and transient LES relaxations, primarily in the upright position, are currently recognized as the main pathophysiological abnormality in gastroesophageal reflux disease (GERD). We investigated the importance of supine acid reflux in patients with GERD. Upon review of their clinical, manometric, pH monitoring and endoscopic characteristics, 85 patients with reflux symptoms were classified into three groups: Group A (n=22), consisting of symptomatic patients without esophagitis or pathological reflux; group B (n=38), symptomatic patients with reflux but no endoscopic esophagitis; and group C (n=25), symptomatic patients with both ulcerative or complicated esophagitis and pathological reflux. All groups were similar in age distribution. Groups B and C had a higher prevalence of hiatal hernia and reflux symptoms. Manometry revealed similar LES pressures in groups A and B, but lower LES pressure in group C (P < 0.005). In groups A and B, supine reflux, in terms of percentage of time with pH < 4, w...Continue Reading

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Citations

Mar 21, 2002·Journal of Gastroenterology and Hepatology·K R DeVault
Aug 24, 2011·World Journal of Gastrointestinal Pathophysiology·Vittorio BresadolaDino De Anna
Oct 16, 2007·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Jacqueline LeeMark Fox
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Jun 6, 2009·The American Journal of Gastroenterology·Joris A BroedersHein G Gooszen
Oct 12, 2019·Acta Paediatrica·Paolo QuitadamoAnnamaria Staiano
Jul 12, 2018·Gastroenterology Research and Practice·Hongfei FangMagnus Halland
Jan 14, 2005·Gastroentérologie Clinique Et Biologique·Thierry Piche

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