Digest
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Previous studies have demonstrated that symptoms are associated with lower pH, longer duration, and more proximal extent of reflux. The study combines the newly introduced impedance recording, which can detect non-acidic reflux, with traditional pH monitoring to assess which features best predict symptoms. The authors confirmed previous findings, that the main determinant of symptoms was refluxate pH, as shown in the figure. Interestingly 14.8% of the symptomatic episodes were only weakly acidic (ph 4-7). Pure gas reflux accounted for around a quarter of all reflux events, but only 3% were associated with symptoms, possibly due to aerosolised acid. Reflux events resulting in regurgitation of fluid were more often associated with gas reflux when compared with those preceding heartburn alone.
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Ghrelin, a motilin related peptide found in gastric endocrine cells, is a growth hormone releasing peptide that also acts as a starvation signalling molecule in the periphery. In
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