Characteristic Of Intragastric Volume And Acid Distribution After Meal In Patients With Gastroesophageal Reflux Disease: Relationship With Postprandial Reflux

Background and ObjectivesIn patients with gastroesophageal reflux disease (GERD), excessive esophageal acid exposure and its related reflux symptoms are most common in postprandial period. It is now generally accepted that in healthy volunteers as well as patients with GERD, tLESRs is one of the most important underlying mechanism of gastroesophageal reflux (GER), especially in the setting of a normal lower esophageal sphincter (LES) pressure. Meal-induced distension of the proximal stomach is a main stimulation that increases tLESRs frequency. Previous studies have shown that in patients with GERD, there were prolonged or enhanced postprandial relaxations of proximal stomach, meal-induced gastric acid secretion and gastric acidity were increased as well. These findings indicate that abnormal proximal gastric function may represent an important pathogenetic mechanism in GERD. However, present knowledge on the potential role of proximal gastric function and acid distribution on the pathogenesis of GERD is limited.The objectives of this study were (1) to observe fasting and postprandial changes of intragastric volume (IGV), and their relationship with esophagogastric junction (EGJ) motility, esophageal clearance and esophageal acid exposure in male patients with GERD, (2) to determine the fasting and postprandial acid distributions in male patients with GERD, and their relationship with esophageal acid exposure. (3) to determine the accuracy of volume measurement with 16 slides spiral CT imaging plus three-domain reconstruction on known volume in vitro.