Acid infusion into the esophagus increases the number of meal‐induced transient lower esophageal sphincter relaxations (TLESRs) in healthy volunteers

• Published in: Neurogastroenterology and motility 2014-10, Vol.26 (10), p.1469-1476
• Main Authors: Halicka, J., Banovcin, P., Halickova, M., Demeter, M., Hyrdel, R., Tatar, M., Kollarik, M.
• Format: Article
• Language: English
• Subjects: acid; Adult; Deglutition; Eating; Esophageal Sphincter, Lower - physiology; esophagus; Esophagus - drug effects; Esophagus - physiology; Female; gastroesophageal reflux; Gastroesophageal Reflux - physiopathology; Gastrointestinal Motility - drug effects; Humans; Hydrogen-Ion Concentration; Male; Manometry; transient lower esophageal sphincter relaxation; vagus nerve; Young Adult
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.12409

Background Transient lower esophageal sphincter relaxation (TLESR) is the major mechanism of gastroesophageal reflux (GER) but the regulation of TLESR by stimuli in the esophagus is incompletely understood. If stimuli in the esophagus can influence TLESR, then such regulation may perpetuate or limit GER. We addressed the hypothesis that acid in the esophagus enhances TLESRs. Methods We evaluated the effect of acid infusion into the distal esophagus on TLESRs evoked by a standard meal in a paired randomized study in healthy subjects. TLESRs were evaluated by using high resolution manometry (HRM). Key Results We found that acid in the esophagus enhanced meal‐induced TLESRs. Compared to control infusion the number of TLESRs (median [interquartile range]) was increased during 2 h following the acid infusion (11 [9–14] vs 17 [12.5–20], p