Obesity: A Challenge to Esophagogastric Junction Integrity

Pandolfino, John E.; El–Serag, Hashem B.; Zhang, Qing; Shah, Nimeesh; Ghosh, Sudip Kumar; Kahrilas, Peter J.

doi:10.1053/j.gastro.2005.12.016

Cited by 491 publications

(341 citation statements)

References 22 publications

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“…High intra-abdominal pressure due to abdominal fat accumulation has been reported to result in an increased gastroesophageal pressure gradient and subsequently facilitate the development of hiatal hernia (10)(11)(12)(13)(14). Among the present male subjects, BMI and the prevalence of diaphragmatic hiatus increased in a concomitant manner during the study period.…”

Section: Discussionmentioning

confidence: 63%

“…GERD has been becoming more prevalent in Asian populations in recent decades, and although the disease is considered to be a common disorder in both Western and Asian populations, its increasing prevalence in Asia may be due to multiple factors, such as the Westernization of eating habits, decrease in the rate of Helicobacter pylori infection, increased gastric acid secretion and a larger elderly population, as well as other factors (2)(3)(4)(5)(6)(7)(8)(9). High intra-abdominal pressure caused by abdominal fat accumulation has been demonstrated to increase the gastroesophageal pressure gradient and incidence of gastroesophageal reflux, while obesity and a high body mass index (BMI) have repeatedly been reported to be correlated with a high prevalence of reflux esophagitis and symptoms of GERD (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). On the other hand, gender differences related to chronological changes in BMI and the prevalence of GERD have not been investigated in Japanese subjects, although a male predominance has been shown to be related to the frequency of reflux esophagitis and GERD (2-5, 8, 9).…”

Section: Introductionmentioning

confidence: 99%

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Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

et al. 2015

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Objective Obesity is related to an increased prevalence of reflux esophagitis and gastroesophageal reflux disease symptoms. This study was performed to clarify the influence of gender on time-course changes in the rate of a high BMI and incidence of reflux esophagitis in Japanese subjects. Results A multiple logistic regression analysis showed that a high BMI, milder degree of gastric mucosal atrophy and larger size of diaphragmatic hiatus were significant predictive factors for the presence of reflux esophagitis in both men and women. The number of male subjects with reflux esophagitis and a high BMI increased during the 10-year examination period. In contrast, the number of individuals with reflux esophagitis and a high BMI was not increased among women. For both men and women, the proportions of patients with a large diaphragmatic hiatus and mild gastric mucosal atrophy increased during the 10-year period. Conclusion The prevalence of reflux esophagitis in the female subjects remained constant over 10 years, different from that observed in the men. A lack of change in BMI may be an important factor accounting for the constant prevalence of reflux esophagitis in women.

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Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

et al. 2015

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“…Other possible parameters are being evaluated such as inspiratory increase (55), integral LES pressure (58), the contractile integral of the EGJ (59) and the valuation of intragastric pressure (60).…”

Section: Current Situationmentioning

confidence: 99%

Practical aspects of high resolution esophageal manometry

Juan¹,

Ríos²,

Bueno³

et al. 2016

Rev Esp Enferm Dig

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High resolution esophageal manometry (HRM) is currently under development as can be seen in the various Chicago classifications. In order to standardize criteria in certain practical aspects with limited scientific evidence, the First National Meeting for Consensus in High Resolution Manometry of the Spanish Digestive Motility Group took place, bringing together a wide group of experts. The proposals were based on a prior survey composed of 47 questions, an exhaustive review of the available literature and the experience of the participants. Methodological aspects relating to the poorly defined analysis criteria of certain new high resolution parameters were discussed, as well as other issues previously overlooked such as spontaneous activity or secondary waves. Final conclusions were drawn with practical applications.

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“…4). HRM has been used recently to define normal patterns of swallow-induced LOS relaxation in considerable detail, enabling better recognition of defects of this function (Pandolfino et al, 2006b).…”

Section: Understanding Abnormal Resistance To Flow Into the Stomach Fmentioning

confidence: 99%

Approaches to driving the evolving understanding of lower oesophageal sphincter mechanical function

Dent

2007

J. Smooth Muscle Res.

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This article reviews and places into context the development of lower oesophageal sphincter (LOS) manometry, the key technique for researching the mechanics of this region. The first of two major challenges, being able to record sphincter pressure accurately with generally available equipment, was solved by the advent of perfused manometry in the 1960s. The other main challenge was to achieve reliable, continuous recording of LOS pressure, despite the constant movements of the LOS relative to the manometric catheter. Though well documented, this challenge is still poorly understood and prioritised, as many clinical/diagnostic and research manometric studies use methods for LOS manometry that are invalidated by LOS movement. There are two techniques that can record continuously from the LOS, despite its movements: high resolution manometry (HRM), which uses multiple point pressure sensors spaced at 1 cm interval or less, and the sleeve, which is a single long sensor. HRM provides valuable additional information on the varied topography of pressure patterns across the gastro-oesophageal junction and how this can change in an individual, second to second. HRM especially, but also sleeve manometry continue to advance understanding of the mechanics of gastro-oesophageal reflux, to unravel the mysteries of the mechanics of hiatus hernia and the diaphragmatic hiatus, to define why antireflux surgery fails or causes dysphagia, to recognise patients with dysphagia due to isolated defects of LOS relaxation and to test novel therapies for reflux disease directed at LOS function. Ample evidence now exists that accurate monitoring of LOS and gastro-oesophageal junction pressures is important for the diagnostic assessment of many patients and for advancing research into several aspects of the mechanical function of the LOS and its surrounding structures. This evidence now needs to be better reflected in the methods used for routine clinical practice and research.

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Obesity: A Challenge to Esophagogastric Junction Integrity

Cited by 491 publications

References 22 publications

Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

Practical aspects of high resolution esophageal manometry

Approaches to driving the evolving understanding of lower oesophageal sphincter mechanical function

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