Holloway R H, Hongo M, Berger K, McCallum R W
Gastroenterology. 1985 Oct;89(4):779-84. doi: 10.1016/0016-5085(85)90572-4.
The occurrence of gastroesophageal reflux after meals may be related to an increase in the rate of transient lower esophageal sphincter (LES) relaxations, the mechanisms of which are not understood. We investigated the effects of gastric distention on LES pressure in 16 normal subjects and 17 patients with gastroesophageal reflux disease. Intraluminal pressure was measured in the gastric fundus, LES, and esophageal body with a manometric catheter incorporating a sleeve device. Gastric distention was performed by injecting 0, 250, 500, or 750 ml of air in randomized order into a balloon and maintaining each stimulus for 15 min. Gastric distention did not significantly alter resting LES pressure in either group. During the basal period the rate of transient LES relaxation in the reflux patients (1.1 +/- 0.4 per 15 min) was greater than that in the normal subjects (0.6 +/- 0.1 per 15 min). Gastric distention resulted in a significant threefold to fourfold increase in the rate of transient LES relaxations in both groups. The reflux patients had a significantly greater proportion of complete relaxations (87%) than did the normal subjects (73%). We conclude that gastric distention, by significantly increasing the rate of transient LES relaxations in both normal subjects and patients with gastroesophageal reflux disease, may contribute to the postprandial increase in gastroesophageal reflux.
餐后胃食管反流的发生可能与一过性下食管括约肌（LES）松弛率增加有关，但其机制尚不清楚。我们研究了胃扩张对16名正常受试者和17名胃食管反流病患者LES压力的影响。使用带有袖套装置的测压导管测量胃底、LES和食管体的腔内压力。通过将0、250、500或750ml空气随机注入气囊并将每种刺激维持15分钟来进行胃扩张。胃扩张在两组中均未显著改变静息LES压力。在基础期，反流患者一过性LES松弛率（每15分钟1.1±0.4次）高于正常受试者（每15分钟0.6±0.1次）。胃扩张导致两组一过性LES松弛率显著增加三到四倍。反流患者完全松弛的比例（87%）显著高于正常受试者（73%）。我们得出结论，胃扩张通过显著增加正常受试者和胃食管反流病患者的一过性LES松弛率，可能导致餐后胃食管反流增加。
