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Related Experiment Videos

Lower esophageal sphincter function in cirrhosis

O T Nebel

    The American Journal of Digestive Diseases
    |December 1, 1977
    PubMed
    Summary

    Cirrhosis does not impair lower esophageal sphincter (LES) function. However, ascites in cirrhosis patients significantly lowers LES pressure, potentially due to sustained increases in gastric pressure.

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    Area of Science:

    • Gastroenterology
    • Hepatology
    • Physiology

    Background:

    • Lower esophageal sphincter (LES) pressure is crucial for preventing gastroesophageal reflux.
    • Cirrhosis, a chronic liver disease, can affect various physiological functions.
    • The impact of cirrhosis and its complications, like ascites, on LES function requires clarification.

    Purpose of the Study:

    • To investigate lower esophageal sphincter (LES) function in patients with cirrhosis.
    • To determine the effect of ascites on LES pressure.
    • To explore the relationship between LES pressure, gastric pressure, and ascites.

    Main Methods:

    • Utilized an infused manometric system to measure LES pressure (LESP).
    • Compared LESP in subjects with cirrhosis, cirrhosis and ascites, and healthy controls.
    • Assessed LES response to pharmacological stimuli (pentagastrin, edrophonium) and physiological maneuvers (straight-leg raising).

    Main Results:

    • LESP in cirrhosis patients was comparable to controls but significantly lower in those with ascites.
    • No significant differences in LES response to stimuli were observed across groups.
    • Removal of ascitic fluid led to a significant increase in LESP and a decrease in gastric pressure (GP).
    • A strong positive linear correlation was found between changes in LESP and GP after ascites removal.

    Conclusions:

    • Cirrhosis itself is not associated with impaired lower esophageal sphincter (LES) function.
    • Ascites significantly reduces LES pressure, suggesting a mechanism related to the LES's inability to counteract chronic increases in gastric pressure.
    • These findings highlight the mechanical influence of ascites on gastroesophageal function in cirrhosis.

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