PMID- 15731939
OWN - NLM
STAT- MEDLINE
DCOM- 20050614
LR  - 20181201
IS  - 0013-726X (Print)
IS  - 0013-726X (Linking)
VI  - 37
IP  - 3
DP  - 2005 Mar
TI  - Relief of reflux symptoms after endoscopic gastroplication may be associated with 
      reduced esophageal Acid sensitivity: a pilot study.
PG  - 236-9
AB  - BACKGROUND AND STUDY AIMS: Although the new endoscopic techniques for the 
      treatment of gastroesophageal reflux disease (GERD) lead to marked clinical 
      benefit, the underlying mechanism of this is unknown. MATERIALS AND METHODS: In 
      this prospective study, the effect of endoscopic gastroplication was investigated 
      in six patients with GERD, who were assessed before and 4 weeks after treatment. 
      The effect on reflux symptoms, quality of life, proton pump inhibitor (PPI) 
      consumption, reflux esophagitis, acid exposure, esophageal motility, lower 
      esophageal sphincter pressure (LESP), and gastric emptying was measured. 
      Esophageal acid sensitivity before and after treatment was investigated using a 
      standardized acid provocation test, and compared with that of six age- and 
      sex-matched healthy controls. RESULTS: Significant clinical benefit and 
      discontinuation of PPI consumption after gastroplication was seen. Among the 
      objectively measured parameters, only acid exposure was significantly reduced and 
      gastric emptying significantly delayed. However, acid exposure remained 
      pathologically high. Esophageal acid sensitivity was significantly reduced. The 
      induction of heartburn and/or pain was abolished in four patients after 
      gastroplication. In two patients the intensity of heartburn/pain was 
      significantly reduced by 40 % or 60 %, and the time to provoke heartburn/pain 
      significantly prolonged by 40% or 100%. CONCLUSION: These preliminary data 
      suggest that the decrease of esophageal sensitivity to acid after endoscopic 
      gastroplication is part of the mechanism responsible for the reduction of reflux 
      symptoms.
FAU - Wenzel, G
AU  - Wenzel G
AD  - Department of Internal Medicine (Med. Klinik II), Klinikum Krefeld, Lutherplatz 
      40, 47805 Krefeld, Germany.
FAU - Kuhlbusch, R
AU  - Kuhlbusch R
FAU - Heise, J
AU  - Heise J
FAU - Frieling, T
AU  - Frieling T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
SB  - IM
MH  - Adult
MH  - *Esophagus
MH  - Female
MH  - Fundoplication/*methods
MH  - Gastric Acid/*metabolism
MH  - Gastroesophageal Reflux/complications/metabolism/*surgery
MH  - *Gastroscopy
MH  - Heartburn/etiology/*metabolism/surgery
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Treatment Outcome
EDAT- 2005/02/26 09:00
MHDA- 2005/06/15 09:00
CRDT- 2005/02/26 09:00
PHST- 2005/02/26 09:00 [pubmed]
PHST- 2005/06/15 09:00 [medline]
PHST- 2005/02/26 09:00 [entrez]
AID - 10.1055/s-2005-860992 [doi]
PST - ppublish
SO  - Endoscopy. 2005 Mar;37(3):236-9. doi: 10.1055/s-2005-860992.