ArticleGut2004
Studies of acid exposure immediately above the gastro-oesophageal squamocolumnar junction: evidence of short segment reflux.
Article in Gut, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00579410 (Evaluation of Esophageal and Gastric Acid Levels in Patients Presenting With Upper Gastrointestinal Symptoms Using a Novel PH System), which is not on this map. Cited by 28 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Esophageal and Gastric Acid Levels in Patients Presenting With Upper Gastrointestinal Symptoms Using a Novel PH System
Who cites it
28 citing papers in PubMed.
- Mechanisms and pathophysiology of Barrett oesophagus.Nature reviews. Gastroenterology & hepatology · 2022Review
- Clinical Features of Esophageal Eosinophilia According to Endoscopic Phenotypes.Internal medicine (Tokyo, Japan) · 2020Article
- Postprandial proximal gastric acid pocket and its association with gastroesophageal acid reflux in patients with short-segment Barrett's esophagus.Journal of Zhejiang University. Science. B · 2020Article
- Lower oesophageal sphincter identification for gastro-oesophageal reflux monitoring: The step-up method revisited with use of basal impedance.United European gastroenterology journal · 2019Article
- Esophageal Motor Dysfunctions in Gastroesophageal Reflux Disease and Therapeutic Perspectives.Journal of neurogastroenterology and motility · 2019Review
- Mechanisms of Barrett's oesophagus (clinical): LOS dysfunction, hiatal hernia, peristaltic defects.Best practice & research. Clinical gastroenterology · 2015Review
- Republished: symptomatic reflux disease: the present, the past and the future.Postgraduate medical journal · 2015Article
- Review
- Tubular duplication of the oesophagus presenting with dysphagia.Singapore medical journal · 2014Article
- Discussing the influence of electrode location in the result of esophageal prolonged pH monitoring.BMC gastroenterology · 2014Article
- Observations of Acid Reflux and Motor Function in Distal Esophagus Using Simultaneous Measurements of Intra-esophageal pH and Pressure in 8 Directions With Novel Sensor Catheter - A Feasibility Study.Journal of neurogastroenterology and motility · 2013Article
- Barrett's Esophagus without dysplasia: wait or ablate?Digestive diseases and sciences · 2011Article
- Esophageal impedance monitoring for gastroesophageal reflux.Journal of pediatric gastroenterology and nutrition · 2011Review
- Pathophysiology and treatment of Barrett's esophagus.World journal of gastroenterology · 2010Review
- Esophagogastric junction distensibility assessed with an endoscopic functional luminal imaging probe (EndoFLIP).Gastrointestinal endoscopy · 2010Article
- Barrett esophagus: an update.Nature reviews. Gastroenterology & hepatology · 2010Review
- Evaluating outcomes of endoscopic full-thickness plication for gastroesophageal reflux disease (GERD) with impedance monitoring.Surgical endoscopy · 2010Article
- Esophagogastric junction distensibility after fundoplication assessed with a novel functional luminal imaging probe.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2010Article
- Liquid in the gastroesophageal segment promotes reflux, but compliance does not: a mathematical modeling study.American journal of physiology. Gastrointestinal and liver physiology · 2008Article
- Diagnostic options for patients with refractory GERD.Current gastroenterology reports · 2008Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsOesophageal pH is conventionally recorded from a point 5 cm above the lower oesophageal sphincter. However, the mucosal changes of reflux oesophagitis and intestinal metaplasia tend to affect the segment of oesophagus distal to this and close to the squamocolumnar junction. This study set out to investigate oesophageal acid exposure of squamous mucosa close to the squamocolumnar junction.
methodsDual channel 24 hour pH monitoring was carried out in 11 patients with endoscopy negative dyspepsia and no evidence of gastro-oesophageal reflux by conventional oesophageal pH metry. Oesophageal pH was recorded from electrodes positioned 5 mm and 55 mm proximal to the squamocolumnar junction. A novel technique was developed using metal clips to secure the pH catheter to the oesophageal mucosa and maintain these electrode positions. Oesophageal manometry indicated that the distal electrode was within the high pressure zone of the lower oesophageal sphincter.
resultsWe found that 24 hour oesophageal acid exposure (per cent time pH <4) was greater 5 mm above the squamocolumnar junction compared with the conventional position 5 cm more proximal (11.7% v 1.8%; p<0.001). The greater acid exposure at the distal versus the conventional site was apparent in both the upright (12.7% v 2.3%) and supine (10.5% v 1.3%) positions, as well as during preprandial (14.2% v 1.6%) and postprandial (21.8% v 2.8%) periods (p<0.001 for each). The number of reflux events recorded close to the squamocolumnar junction was also higher than at the conventional position (168 v 33; p<0.001). There was no correlation between acid exposure at the two sites.
conclusionsThe squamous mucosa of the most distal oesophagus is exposed to substantial acidic reflux, even in patients without evidence of conventional reflux disease. This short segment reflux may explain the high incidence of metaplasia and neoplasia at the gastro-oesophageal junction.
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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.