Gastro-oesophageal function in duodenal ulcer patients.

An investigation of the gastro-oesophageal region was made in 39 patients with uncomplicated duodenal ulcer (DU). The results were compared with the results from a group of normal volunteers. The DU patients had a lower gastro-oesophageal sphincter pressure (p less than 0.05) and a reduced acid-clearing ability (p less than 0.05). Furthermore, an increased acid gastro-oesophageal reflux (p less than 0.05) and a greater number of reflux episodes lasting longer than usual (p less than 0.05) were demonstrated. There was a positive correlation between low gastro-oesophageal sphincter pressure and acid gastro-oesophageal reflux within the pH intervals 0--3 and 0--4. The peristaltic activity was measured by the number of pressure amplitudes registered in the upper and lower part of the oesophagus; an increase (p less than 0.05) in pressure amplitudes in the lower part was found in the DU patients. When time relationship was used to distinguish between propagating, simultaneous, and reversed peristaltic activity, an increase in reversed peristaltic activity (p less than 0.001) was demonstrated in DU patients. The conclusion is that DU patients have an increased acid gastro-oesophageal reflux, probably as a result of an incompetence in the gastro-oesophageal sphincter barrier, and a reduced acid-clearing ability. The peristaltic activity is increased during the reflux episodes, although this investigation does not determine whether this is due to an increased reflux volume or an insufficient peristaltic activity.