Digest
- Robin Spiller,
- Alastair Watson, Editor and Deputy Editor
WHAT DETERMINES SYMPTOMS IN GASTRO-OESOPHAGEAL REFLUX?
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.
See p 313
GHRELIN STIMULATES GASTRIC MOTILITY BY A MOTILIN INDEPENDENT PATHWAY
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 animals it stimulates food intake and accelerates gastric emptying. Blood levels rise during an overnight fast and fall to their lowest level after breakfast. The current study showed that a supra-physiological infusion caused a striking stimulation of …
