[Simultaneous study of tones of the lower esophageal sphincter and proximal stomach in healthy humans].

OBJECTIVES

The aim of this study was to determine the feasibility and tolerance of simultaneous assessment of the proximal gastric and lower esophageal sphincter tones in healthy humans, in fasting and fed conditions.

METHODS

Esophageal motility and lower esophageal sphincter tone were measured on two separate days in 7 healthy subjects. During one of these sessions, proximal gastric tone was simultaneously assessed with a balloon placed in the proximal stomach and connected to an electronic barostat. Motility was monitored 1 hour before and 4 hours after a liquid fat meal (400 mL/600 kcal). In four other healthy subjects, simultaneous assessment of proximal gastric and lower esophageal sphincter tones was performed after, suggestion of a 200 mL/200 kcal liquid meal.

RESULTS

Simultaneous use of gastric barostat and esophageal motility device was well tolerated in 10/11 healthy subjects. The presence of the barostat balloon did not significantly affect basal lower esophageal sphincter tone and the rate of transient lower esophageal sphincter relaxations. The important fall of lower esophageal sphincter basal tone after ingestion of the 400 mL/600 kcal meal did not allow to detect a post-prandial increase of transient lower esophageal sphincter; relaxations. After ingestion of the 200 mL/200 kcal meal, the incidence of transient lower esophageal sphincter relaxations increased (p < 0.02 vs. fasting). Maximal gastric relaxation was reached 15 min after meal, and appeared shorter (112 +/- 17 min vs. 167 +/- 24 min) and more pronounced (292 +/- 26 mL vs. 190 +/- 51 mL) than after the 400 mL meal, but differences were not statistically significant.

CONCLUSIONS

Simultaneous assessment of proximal gastric and lower esophageal sphincter tone is feasible, after oval ingestion of a meal. Since the 400 mL meal induces in important inhibition of lower esophageal sphincter basal tone, the 200 mL meal seems more adequate for assessment of the transient lower esophageal sphincter relaxations.