ArticleGastroenterology2001
Unbuffered highly acidic gastric juice exists at the gastroesophageal junction after a meal.
Article in Gastroenterology, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers.
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Who cites it
70 citing papers in PubMed, 329 citations in OpenAlex.
- Exploratory analyses of meal-induced heartburn identify distinct clinical phenotypes of gastroesophageal reflux disease.Physiological reports · 2025Trial
- Randomised clinical trial: the effectiveness of Gaviscon Advance vs non-alginate antacid in suppression of acid pocket and post-prandial reflux in obese individuals after late-night supper.Alimentary pharmacology & therapeutics · 2020Trial
- Volume, distribution and acidity of gastric secretion on and off proton pump inhibitor treatment: a randomized double-blind controlled study in patients with gastro-esophageal reflux disease (GERD) and healthy subjects.BMC gastroenterology · 2015Trial
- Gaviscon Double Action Liquid (antacid & alginate) is more effective than antacid in controlling post-prandial oesophageal acid exposure in GERD patients: a double-blind crossover study.Alimentary pharmacology & therapeutics · 2014Trial
- Rabeprazole vs esomeprazole in non-erosive gastro-esophageal reflux disease: a randomized, double-blind study in urban Asia.World journal of gastroenterology · 2005Trial
- Comprehensive assessment of gastroscopic findings and quality of life using the GERD-HRQL questionnaire following single anastomosis sleeve ileal (SASI) bypass.Langenbeck's archives of surgery · 2026Article
- The pathogenesis and surgical treatment progress of gastroesophageal reflux disease.Frontiers in surgery · 2026Review
- Pathophysiology of Gastroesophageal Reflux Disease.Digestion · 2026Review
- Gastric Mixing and Acid Diffusion in a Human Stomach Simulated Using Smoothed Particle Hydrodynamics.Journal of food science · 2025Article
- Pathophysiology of gastro-oesophageal reflux disease: implications for diagnosis and management.Nature reviews. Gastroenterology & hepatology · 2024Review
- Characteristics of proton pump inhibitor-resistant severe reflux esophagitis and efficacy of vonoprazan in elderly (older than 75 years) and non-elderly groups.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Topical Alginate Protection against Pepsin-Mediated Esophageal Damage: E-Cadherin Proteolysis and Matrix Metalloproteinase Induction.International journal of molecular sciences · 2023Article
- Gastroesophageal reflux disease in children: What's new right now?World journal of gastrointestinal endoscopy · 2023Review
- EsReflux Protocol: Epidemiological Study of Heartburn and Reflux-like Symptoms in Spanish Community Pharmacies.International journal of environmental research and public health · 2022Article
- Consensus statements and recommendations on the management of mild-to-moderate gastroesophageal reflux disease in the Southeast Asian region.JGH open : an open access journal of gastroenterology and hepatology · 2021Article
- Evaluations of Gastric Acid Pocket Using Novel Vertical 8-Channel pH Monitoring System and Effects of Acid Secretion Inhibitors.Journal of neurogastroenterology and motility · 2021Article
- Prevalence of behavioral disorders in patients with vonoprazan-refractory reflux symptoms.Journal of gastroenterology · 2021Article
- Pharmacological Management of Gastro-Esophageal Reflux Disease: An Update of the State-of-the-Art.Drug design, development and therapy · 2021Review
- A semi dynamicCurrent research in food science · 2021Article
- Bottom-Up Physiologically Based Oral Absorption Modeling of Free Weak Base Drugs.Pharmaceutics · 2020Article
10 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsGastroesophageal reflux typically occurs after meals. During dual gastric and esophageal pH monitoring, we observed that postprandial refluxate was often more acidic than the gastric contents. This study aimed to investigate this phenomenon.
methodsDual gastric and esophageal pH tracings were analyzed from 40 dyspeptic patients. Dual pH electrode pull-through studies were performed in healthy volunteers to document regional variation in intragastric pH under both fasting and postprandial conditions. The squamocolumnar junction was identified using radio-opaque endoscopic clips. We also examined in vitro partitioning of gastric juice added to a homogenized fatty meal.
resultsThe dual pH traces confirmed that esophageal refluxate was frequently more acidic than the body of the stomach after meals but not during fasting. The pull-through studies showed a pocket of acid at the gastroesophageal junction that escaped the buffering effect of meals, remaining highly acidic (median pH 1.6) compared with the body of the stomach (pH 4.7; P < 0.001). This proximal acid pocket extended from the cardia across the squamocolumnar junction 1.8 cm into the distal esophagus. The in vitro studies showed that acidic gastric juice could partition on top of a homogenized fatty meal.
conclusionsAfter eating, highly acidic unbuffered gastric juice is present at the gastroesophageal squamocolumnar junction and is likely to contribute to the high prevalence of disease at this site.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.