Part of this work was accepted for the Annual Meeting of the American Gastroenterological Association, Orlando, May, 1999 and published in abstract form in Gastroenterology 1999;116: A1077.
Elicitation of transient lower oesophageal sphincter relaxations in response to gastric distension and meal ingestion
Version of Record online: 11 DEC 2002
Neurogastroenterology & Motility
Volume 14, Issue 6, pages 647–655, December 2002
How to Cite
Scheffer, R. C. H., Akkermans, L. M. A., Bais, J. E., Roelofs, J. M. M., Smout, A. J. P. M. and Gooszen, H. G. (2002), Elicitation of transient lower oesophageal sphincter relaxations in response to gastric distension and meal ingestion. Neurogastroenterology & Motility, 14: 647–655. doi: 10.1046/j.1365-2982.2002.00366.x
- Issue online: 11 DEC 2002
- Version of Record online: 11 DEC 2002
- Received: 13 December 2001 Accepted for publication: 18 June 2002
- gastric barostat;
- gastric distension;
- meal-induced adaptive relaxation;
- oesophageal manometry;
AbstractThe aim of this study was to compare the effect of graded gastric barostat distension and meal-induced fundic relaxation on the elicitation of transient lower oesophageal sphincter relaxation (TLOSR). In 15 healthy subjects, stepwise fundic distension and oesophageal manometry were performed simultaneously. Next, the effect of meal ingestion on proximal stomach volume and lower oesophageal sphincter function was studied. During stepwise barostat distension of the proximal stomach, a significant linear correlation between intragastric pressure (r = 0.91; P < 0.01) and the TLOSR rate during inflation and subsequent deflation (r = 0.96; P < 0.01) was found. A similar relationship was found for volume. In addition, after meal ingestion, the TLOSR rate increased significantly from 1.40 ± 3 to 5.4 ± 1.5 h−1 (P < 0.01) and 5.2 ± 1.7 h−1 (P < 0.01), respectively, during the first and second 30-min postprandially. However, at similar calculated intragastric volumes, barostat distension led to a significantly higher TLOSR rate than the meal. Similarly, distension-induced increase in gastric wall tension, estimated from the measured bag pressure and volume using Laplace's law, was associated with significantly higher TLOSR rates (P < 0.01). In conclusion, the rate of TLOSRs in healthy volunteers is directly related to the degree of proximal gastric distension and pressure-controlled barostat distension is a more potent trigger of TLOSRs than a meal. The latter finding suggests that tension receptor activation is an important stimulus for TLOSRs.