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The time pattern of gastroesophageal reflux
K Gudmundsson1, F Johnsson, B Joelsson
1Dept. of Surgery, Lund University, Sweden.
Scandinavian Journal of Gastroenterology
|January 1, 1988
Summary
Gastroesophageal reflux disease (GERD) shows a distinct 24-hour pattern, peaking in the evening. This finding suggests tailored medical therapy timing for GERD patients may improve treatment outcomes.
Area of Science:
- Gastroenterology
- Digestive Health
- Esophageal Physiology
Background:
- Gastroesophageal reflux disease (GERD) affects a significant portion of the population.
- Understanding the temporal patterns of GERD is crucial for effective management.
- Previous studies have not fully characterized the diurnal variations in esophageal reflux.
Purpose of the Study:
- To analyze the 24-hour variations in gastroesophageal reflux.
- To identify specific time periods with increased reflux episodes.
- To correlate reflux patterns with esophageal pressure and patient conditions.
Main Methods:
- Ambulatory 24-hour esophageal pH-monitoring in 220 GERD patients and 50 controls.
- Identification of distinct reflux periods: daytime, evening, and night.
- Measurement of distal esophageal high-pressure zone (HPZ) pressure at different times.
Main Results:
- Gastroesophageal reflux was highest during the evening (1700-2400 h).
- This evening peak persisted even after excluding postprandial reflux.
- Lower distal esophageal HPZ pressure was observed in the late afternoon (1600 h).
- The reflux pattern was most pronounced in patients with esophagitis.
Conclusions:
- A distinct diurnal pattern of gastroesophageal reflux exists, with a significant evening peak.
- Reduced esophageal high-pressure zone pressure in the afternoon may contribute to increased reflux.
- These findings have important implications for optimizing the timing of medical therapy for GERD.