Relationship between Gastro-Oesophageal Acid Reflux, Basal Gastro-Oesophageal Sphincter Pressure, and Gastric Acid Secretion

Abstract

Twelve-hour continuous pH-recording at the distal end of the oesophagus and measurement of basal gastro-oesophageal sphincter pressure with perfused catheters were carried out in 108 subjects. Fasting gastric secretion, basal secretion, and maximal acid secretion after subcutaneous injection of 6 μg pentagastrin/kg bodyweight were determined additionally in some of the subjects. There was a significant inverse correlation between the results of continuous pH-recording and basal gastro-oesophageal sphincter pressure, which confirms the relationship between low sphincter pressure and gastro-oesophageal acid reflux. Furthermore, there was a significant direct correlation between the results of continuous pH-recording and the volume of basal secretion and the basal acid output. These findings emphasize the significance of gastric acid secretion for the results of continuous pH-recording. As reflux-preventive surgery may elicit alterations in the variables of acid secretion, the results of continuous pH-recording do not allow conclusions to be drawn with regard to the effectiveness of a surgically established gastro-oesophageal barrier.

Key-words:

• Gastric acid
• gastric regurgitation
• gastro-oesophageal reflux
• gastro-oesophageal sphincter pressure
• manometry
• pentagastrin
• pH-measurements