弯曲运动对有症状患者胃食管反流的影响。

Effect of bending exercise on gastroesophageal reflux in symptomatic patients.

作者信息

Sodhi Jaswinder Singh, Zargar Showkat Ali, Javid Gul, Khan Mushtaq A, Khan Bashir A, Yattoo G N, Shah Altaf, Gulzar G M, Shoukat Abid

机构信息

Department of Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.

出版信息

Indian J Gastroenterol. 2008 Nov-Dec;27(6):227-31.

PMID:19405255

Abstract

BACKGROUND

Recumbency and bending are thought to provoke symptoms of reflux in patients with gastroesophageal reflux disease (GERD). The effect of exercise which involved bending and abdominal contractions was evaluated in symptomatic patients of GERD using continuous 24-hour ambulatory esophageal pH test.

METHODS

Twenty-five patients with GERD, confirmed by abnormal 24-hour esophageal pH study, performed exercise for 30 minutes consisting of 5 sessions of 6 minutes each. The exercise involved toe touching from supine, sitting and standing position of 2 minutes' duration each. Each 2 minutes' period included 8 repetitions of the same exercise of 15 seconds' duration. 24-hour esophageal pHmetry was done on day 1 without exercise and on day 2 with 30-minute exercise. Reflux time percent (RT%) pH <4 was compared between days 1 and 2 and 30 minutes before and during exercise.

RESULTS

Fourteen patients were upright refluxers and 11 patients were combined refluxers, which included 4 patients with supine reflux and 7 patients who refluxed both in supine and upright positions. The median (range) 24-hour RT% on day 1 and day 2 was 7 (5-40) and 7 (4-46), respectively (p=0.15). RT% during 30 minutes exercise compared with 30 minutes before exercise was 6.6 (0-60) and 0.0 (0.0-80) (p=0.02), respectively. In combined and upright refluxers, RT% during and before exercise was 13 (0-53) and 0.0 (0.0-42) (p=0.008), respectively and 0.0 (0-60) and 0.0 (0-80), (p=0.71), respectively. RT% between upright and combined refluxers during exercise was 0.0 (0-60) and 13 (0-53), respectively (p=0.004). The mean (SD) LES pressure in mmHg in combined and upright refluxers was 7 (2.9) and 19.6 (6.8), respectively (p=0.008). Esophagitis in combined and upright refluxers was seen in 8 patients (72.7%) and 2 patients (14.3%), respectively. Two patients (8%) developed symptoms during exercise.

CONCLUSION

Exercise which involves bending precipitates reflux in patients with moderate-to-severe GERD.

摘要

背景

人们认为卧位和弯腰会诱发胃食管反流病（GERD）患者出现反流症状。本研究通过连续24小时动态食管pH监测，评估了涉及弯腰和腹部收缩的运动对有症状的GERD患者的影响。

方法

25例经24小时食管pH研究异常确诊的GERD患者进行了30分钟的运动，包括5组，每组6分钟。运动包括从仰卧位、坐位和站立位触摸脚趾，每个姿势持续2分钟。每个2分钟的时间段包括8次持续15秒的相同运动重复。在第1天未进行运动时和第2天进行30分钟运动后进行24小时食管pH监测。比较第1天和第2天以及运动前30分钟和运动期间pH<4的反流时间百分比（RT%）。

结果

14例患者为直立位反流者，11例患者为混合型反流者，其中包括4例仰卧位反流患者和7例仰卧位和直立位均反流的患者。第1天和第2天的24小时RT%中位数（范围）分别为7（5 - 40）和7（4 - 46）（p = 0.15）。运动30分钟期间的RT%与运动前30分钟相比分别为6.6（0 - 60）和0.0（0.0 - 80）（p = 0.02）。在混合型和直立位反流者中，运动期间和运动前的RT%分别为13（0 - 53）和0.0（0.0 - 42）（p = 0.008），以及0.0（0 - 60）和0.0（0 - 80）（p = 0.71）。运动期间直立位反流者和混合型反流者的RT%分别为0.0（0 - 60）和13（0 - 53）（p = 0.004）。混合型和直立位反流者的平均（标准差）LES压力（以mmHg为单位）分别为7（2.9）和19.6（6.8）（p = 0.008）。混合型和直立位反流者中分别有8例（72.7%）和2例（14.3%）出现食管炎。2例患者（8%）在运动期间出现症状。