Schoeman M N, Tippett M D, Akkermans L M, Dent J, Holloway R H
Gastroenterology Unit, Royal Adelaide Hospital, South Australia.
Gastroenterology. 1995 Jan;108(1):83-91. doi: 10.1016/0016-5085(95)90011-x.
BACKGROUND/AIMS: Investigation of the motor events underlying gastroesophageal reflux has largely been confined to resting, recumbent subjects. The motor events associated with reflux during physical activity remain unknown. The aim of this study was to investigate the patterns of lower esophageal sphincter (LES) function underlying reflux in healthy subjects and the effect of exercise and physical activity on reflux mechanisms.
LES pressure was recorded with a perfused sleeve sensor in 10 healthy subjects; intraluminal transducers recorded pressure in the stomach, esophagus, and pharynx, and pH was recorded 5 cm above the LES. Signals were stored in a portable data-logger. Recordings were made for 24 hours, including moderate physical activity, periods of rest and sleep, standardized meals, and standardized exercise.
Most reflux episodes (81 of 123; 66%) occurred in the 3 hours after food intake; only 2 episodes occurred during exercise. LES pressure was < or = 3 cm H2O in 79% of reflux episodes. Transient LES relaxation was the mechanism of reflux in 82% of episodes, irrespective of activity or body position, whereas swallow-related LES relaxations accounted for 13% and persistently absent LES pressure accounted for 1%. Straining occurred in only 20% of episodes.
In ambulant healthy subjects, accurate continuous recording of LES function is possible, reflux usually occurs during transient LES relaxations, and straining is not a major factor in the induction of reflux.
背景/目的：对胃食管反流潜在运动事件的研究主要局限于静息、卧位的受试者。身体活动期间与反流相关的运动事件仍不清楚。本研究的目的是调查健康受试者反流时食管下括约肌（LES）功能的模式以及运动和身体活动对反流机制的影响。
用灌注袖套传感器记录10名健康受试者的LES压力；腔内换能器记录胃、食管和咽部的压力，在LES上方5 cm处记录pH值。信号存储在便携式数据记录器中。记录24小时，包括适度身体活动、休息和睡眠时段、标准化餐食以及标准化运动。
大多数反流事件（123例中的81例；66%）发生在进食后3小时内；仅2例发生在运动期间。79%的反流事件中LES压力≤3 cm H2O。无论活动或体位如何，82%的事件中反流机制为LES短暂松弛，而吞咽相关的LES松弛占13%，LES压力持续缺失占1%。仅20%的事件中出现用力情况。
在活动的健康受试者中，能够准确连续记录LES功能，反流通常发生在LES短暂松弛期间，用力不是诱发反流的主要因素。
