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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Postprandial proximal gastric acid pocket and gastric pressure in patients after gastric surgery

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Author(s):
Herbella, F. A. M. [1] ; Vicentine, F. P. P. [1] ; Del Grande, J. C. [1] ; Patti, M. G. [2]
Total Authors: 4
Affiliation:
[1] Univ Fed Sao Paulo, Escola Paulista Med, Dept Surg, Sao Paulo - Brazil
[2] Univ Chicago, Dept Surg, Chicago, IL 60637 - USA
Total Affiliations: 2
Document type: Journal article
Source: Neurogastroenterology and Motility; v. 23, n. 1, p. 52-E4, JAN 2011.
Web of Science Citations: 11
Abstract

Background An unbuffered postprandial proximal gastric acid pocket (PPGAP) has been demonstrated in normal individuals (NI) and patients with gastro-esophageal reflux disease (GERD). The role of gastric anatomy and gastric motility in the physiology of the PPGAP remains elusive. This study aims to analyze the correlation of PPGAP with proximal gastric pressure after gastric surgery. Methods A total of 26 individuals were studied: eight patients after open Roux-en-Y gastric bypass (RYGB) for morbid obesity, six patients after laparoscopic Nissen fundoplication for GERD, seven patients after open subtotal gastrectomy for gastric cancer and five NI. Patients underwent high resolution manometry to identify the location of the lower border of the lower esophageal sphincter (LBLES) and measure gastric pressure 1, 2, 3, 4 and 5 cm below the LBLES, immediately before swallow and after the end of the LES relaxation. A station pull-through pH monitoring was performed in all but NI, from 5 cm below the LBLES to the LBLES in increments of 1 cm in a fasting state and 10 min after a standardized fatty meal. Key Results Our results show that: (i) proximal gastric pressures are lower after swallow compared with before swallow in NI; (ii) patients after gastric surgery tend to have higher gastric pressure before and lower after swallow compared with NI and (iii) patients after RYGB with PPGAP have an increased gastric pressure after swallows in the segment where the PPGAP is noticed. Conclusions \& Inferences Gastric motility may play a role in the genesis of PPGAP in patients after RYGB. The contribution of gastric motility for the genesis of PPGAP is still elusive in other patients. (AU)

FAPESP's process: 07/07940-8 - Evaluation of the gastric acid pocket in patients submitted to Roux-en-Y gastric bypass
Grantee:Fernando Augusto Mardiros Herbella Fernandes
Support Opportunities: Regular Research Grants