, Volume 17, Issue 5, pp 415-422

A test of gastroesophageal sphincter competence

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Abstract

Gastroesophageal manometrics, using continuously perfused polyvinyl tubes, and acid reflux (pH test) were studied prospectively in 13 patients with, and 14, without symptoms and/or signs of gastroesophageal reflux. Pressures were recorded simultaneously from stomach, gastroesophageal sphincter and distal esophagus at rest and during gradual abdominal compression to 80 mm Hg. Neither the mean resting pressures nor the mean increase in gastric or sphincter pressures, during abdominal compression, were significantly different (P>0.10). Sphincteric yield pressures did not separate the 2 groups. However, the mean esophageal pressure rise was significantly greater (P<0.001) in the symptomatic patients (34±4.5 vs 9.9±3.2 mm Hg). The mean pressure in the stomach, sphincter and esophagus became almost identical in the symptomatic patients—a “common cavity” occurred between stomach and esophagus. Two symptomatic patients had negative pH but positive common cavity tests. No asymptomatic patient had evidence of either reflux or a positive common cavity test.

Supported by the Denver Veterans Administration Hospital Training Grant in Gastroenterology, TR 110, and by the National Institute of Health Training Grant in Gastroenterology, AM 5122.