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Nocturnal Antral pH Rises Are Related to Duodenal Phase III Retroperistalsis

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Abstract

The mechanisms behind nocturnal rises of gastricpH are unknown. We have analyzed the relation betweeninterdigestive duodenal peristalsis and nocturnal pH inthe gastric antrum. Simultaneous recording of antroduodenal pressures and intragastric pHwas performed in 11 healthy subjects (six men, fivewomen) overnight for 8 hr, using a catheter with sevenpressure recording points and an antral glass pH electrode. Three pressure recording sites wereclosely spaced in the descending duodenum. Altogether 46phase III activities were recorded. A retroperistalticsequence in the last part of phase III was observed in 31 phase III activities (67.4%),while 15 phase III activities lacked retroperistalsis.All subjects had retroperistalsis in at least one phaseIII at night with a median of 60% (52-100%) (interquartile range). The duration of thewhole phase III was 5.1 (3.1-7.0) min, whereas theduration of the retroperistaltic period was 2.0(1.5-3.2) min, corresponding to 45% (23-64%) of theduration of phase III. The peak of antral pH occurred7.4 (6.0-13.0) min from the start of the phase III inthe duodenum and and the rise in pH lasted for 8.0(4.8-12.0) min. Measurement of pH for a period of 10 min before and after phase III, demonstrated anincrease in median pH from 1.2 (1.1-1.9) to 3.2(1.6-4.7), respectively (P < 0.001). Phase IIIactivities without duodenal retroperistalsis were notfollowed by a significant antral pH change (median 1.7vs 1.8 before and after phase III, respectively).Increases of pH unrelated to phase III were uncommon,only 1.0 (1.0-2.2) events per night were observed and lasted for a short period of time, 2.1(0.5-3.2) min. The results indicate that the cyclic risein antral pH at night is due to a physiologicalduodenogastric reflux, caused by duodenalretroperistalsis in phase III. This reflux may play a role inprotection of the antral mucosa.

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Authors
  1. Einar S. Bjornsson
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  2. Hasse Abrahamsson
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Bjornsson, E.S., Abrahamsson, H. Nocturnal Antral pH Rises Are Related to Duodenal Phase III Retroperistalsis. Dig Dis Sci 42, 2432–2438 (1997). https://doi.org/10.1023/A:1018835806251

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