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Severe reflux disease is associated with an enlarged unbuffered proximal gastric acid pocket
A T Clarke1, A A Wirz, J J Manning
1Division of Cardiovascular and Medical Sciences, University of Glasgow, 44 Church Street, Western Infirmary, Glasgow G11 6NT, UK.
Background:
An unbuffered pocket of highly acidic juice is observed at the gastric cardia after a meal in healthy subjects.
Aims:
To compare the postprandial acid pocket in healthy subjects and patients with severe reflux disease and define its position relative to anatomical and manometric landmarks.
Methods:
12 healthy subjects and 16 patients with severe reflux disease were studied. While fasted, a station pull-through was performed using a combined dual pH and manometry catheter. Position was confirmed by radiological visualisation of endoscopically placed radio-opaque clips. The pull-through study was repeated 15 min after a standardised fatty meal. Barium meal examination was performed before and following the meal.
Results:
A region of unbuffered acid (pH
Conclusion:
This enlarged region of unbuffered postprandial acidic juice observed in the patients just below the gastro-oesophageal junction may contribute to the aetiology of severe reflux disease.
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