Lee Hong Sub, Noh Chung Kyun, Lee Kwang Jae
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea.
Department of Gastroenterology, Seonam University College of Medicine, Myongji Hospital, Goyang, Gyeonggi-do, Korea.
J Neurogastroenterol Motil. 2017 Jan 30;23(1):72-79. doi: 10.5056/jnm16119.
BACKGROUND/AIMS: Little research has been done to evaluate the effect of stress in exacerbating the symptoms associated with gastroesophageal reflux (GER). We aimed to investigate the effect of acute stress on esophageal motility and GER parameters in healthy volunteers.
A total of 10 (M:F = 8:2, median age 34 years-old) healthy volunteers without any recurrent gastrointestinal symptoms participated in this study. They underwent esophageal high-resolution manometry with 10 wet swallows (Experiment I) and esophageal impedance-pH monitoring (Experiment II) in the basal period and in the stress period. In the stress period, either real stress or sham stress was given in a randomized cross-over design. The stress scores, symptom severity, and pulse rates were measured.
The stress scores and the severity of nausea were significantly greater under real stress, compared with sham stress. The percentages of weak, failed, rapid, premature, and hyper-contractile contractions were not significantly altered during real stress and during sham stress, compared with the basal period. The median resting pressure of the lower esophageal sphincter and distal contractile integral of esophageal contractions did not differ in the stress period, compared with the basal period. Contractile front velocity and distal latency of esophageal peristaltic contractions were significantly changed during real stress, which was not observed during sham stress. GER parameters were not significantly altered during real stress and during sham stress.
Although acute auditory and visual stress seems to affect esophageal body motility, it does not induce significant motor abnormalities or increase GER in healthy humans.
背景/目的：关于压力在加重胃食管反流（GER）相关症状方面的影响，所做研究甚少。我们旨在调查急性应激对健康志愿者食管动力和GER参数的影响。
共有10名（男:女 = 8:2，中位年龄34岁）无任何复发性胃肠道症状的健康志愿者参与本研究。他们在基础期和应激期接受了10次湿吞咽的食管高分辨率测压（实验I）和食管阻抗-pH监测（实验II）。在应激期，采用随机交叉设计给予真实应激或假应激。测量应激评分、症状严重程度和脉搏率。
与假应激相比，真实应激下的应激评分和恶心严重程度显著更高。与基础期相比，真实应激和假应激期间弱收缩、无效收缩、快速收缩、过早收缩和高收缩性收缩的百分比无显著变化。与基础期相比，应激期食管下括约肌的中位静息压力和食管收缩的远端收缩积分无差异。食管蠕动收缩的收缩前沿速度和远端潜伏期在真实应激期间显著改变，而在假应激期间未观察到这种情况。真实应激和假应激期间GER参数无显著改变。
尽管急性视听应激似乎会影响食管体部动力，但在健康人群中它不会诱发明显的运动异常或增加GER。
