Commentaries

The acid pocket and its relevance to reflux disease

Richard H Holloway¹, Daniel A Sifrim²

¹ Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Discipline of Medicine, University of Adelaide, Adelaide, South Australia
² Centre for Gastroenterological Research, KU Leuven, Belgium

Correspondence to:
Professor Richard H Holloway, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia; rhollowa@mail.rah.sa.gov.au

The first 150 words of the full text of this article appear below.

Gastric pH is one of the primary determinants of gastro-oesophageal reflux disease (GORD). The severity of both oesophageal mucosal damage and symptoms is directly related to the pH of the refluxate and thereby intragastric pH. The proximal stomach is particularly relevant as it is the most immediate source of the refluxate, particularly in patients with hiatus hernia. An important characteristic of gastro-oesophageal reflux is the postprandial increase in reflux episodes. Indeed, the majority of reflux episodes in most patients occur in the postprandial period. However, meals lead to transient buffering of gastric acid, particularly in the proximal stomach,^{1 2} yet, early in the postprandial period, acid and weakly acidic reflux episodes are often interspersed.³ Conventional intragastric pH monitoring 5 cm below the lower oesophageal sphincter (LOS) often reveals discrepancies between gastric pH and that of the refluxate in the oesophagus, with a lower pH in the oesophagus than in the stomach . . . [Full text of this article]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Severe reflux disease is associated with an enlarged unbuffered proximal gastric acid pocket

A T Clarke, A A Wirz, J J Manning, S A Ballantyne, D J Alcorn, and K E L McColl
Gut 2008 57: 292-297. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Ghosh, S. K., Kahrilas, P. J., Brasseur, J. G. (2008). Liquid in the gastroesophageal segment promotes reflux, but compliance does not: a mathematical modeling study. Am. J. Physiol. Gastrointest. Liver Physiol. 295: G920-G933 [Abstract] [Full Text]