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The gastric cardia represents a transition zone between the squamous epithelium of the oesophagus and the oxyntic epithelium of the body of the stomach. Virtually absent in the neonate and probably a metaplastic response to acid exposure, it is a site of high prevalence of pathology, particularly neoplasia. The authors use a high definition pH probe clipped to the gastro-oesophageal junction, which allowed simultaneous reading of pH at 12 sites over a 10 cm length. Probes within the cardia showed a high pH during the fasting period. Postprandially, a distinct acid pocket pH<4 (see fig) developed after about 30 minutes and remained acidic for the next hour, while probes within the body of the stomach showed pH>4 due to acid buffering by the food. The pocket of acid in the cardia was the source of postprandial acid reflux (see fig). Acidification of the cardia following postprandially is postulated to be
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