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Volume 130, Issue 2, Pages (February 2006)

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Presentation on theme: "Volume 130, Issue 2, Pages (February 2006)"— Presentation transcript:

1 Volume 130, Issue 2, Pages 334-340 (February 2006)
Intermittent Spatial Separation of Diaphragm and Lower Esophageal Sphincter Favors Acidic and Weakly Acidic Reflux  Albert J. Bredenoord, Bas L.A.M. Weusten, Robin Timmer, André J.P.M. Smout  Gastroenterology  Volume 130, Issue 2, Pages (February 2006) DOI: /j.gastro Copyright © 2006 American Gastroenterological Association Terms and Conditions

2 Figure 1 Radiographic images taken during the validation study. (A) The metal clip at the squamocolumnar junction (arrow) is visible at the level of the diaphragm, located between the first and second ring on the catheter. Osteosynthesis material is present at the left humerus. (B) Radiographic image of the same subject 30 minutes after the previous image. The metal clip at the squamocolumnar junction is located proximal to the second ring on the catheter. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2006 American Gastroenterological Association Terms and Conditions

3 Figure 2 Distance between the endoscopically placed clip and the proximal margin of the diaphragm during the single and double pressure peak periods. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2006 American Gastroenterological Association Terms and Conditions

4 Figure 3 Contour plots of a single and double high-pressure zone configuration. In these plots, pressure amplitudes are presented in colors. A shows 1 high-pressure zone (HPZ). A dry swallow is marked with an arrow. B shows a tracing in the same patient when the proximal and distal HPZ are spatially separated. Relaxation of both components occurs during a dry swallow (arrow). The respiratory pressure variations are much larger in the distal HPZ (diaphragm). Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2006 American Gastroenterological Association Terms and Conditions

5 Figure 4 Reflux rate (episodes per hour) during the reduced (single pressure peak, open bars) and unreduced (double pressure peak, gray bars) hernia state. Significantly higher reflux rates were found during the unreduced state. *P ≤ .05. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2006 American Gastroenterological Association Terms and Conditions

6 Figure 5 Mechanisms of reflux during the reduced (open bars) and unreduced (gray bars) hernia state. TLESRs were the most prevalent reflux mechanism during the reduced state. The increase in reflux rate in the unreduced state is due to other reflux mechanisms. *P ≤ .05. Gastroenterology  , DOI: ( /j.gastro ) Copyright © 2006 American Gastroenterological Association Terms and Conditions


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