We aim to investigate the association between reflux episodes and supragastric belches using the technique of combined HRM and impedance monitoring.
ID
Source
Brief title
Condition
- Gastrointestinal motility and defaecation conditions
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The occurrence of a specific gastroesophageal pressure-flow pattern preceding
or during a supragastric belch coinciding with a reflux episode.
Secondary outcome
The number of supragastric belches
The number esophageal reflux episodes
Background summary
The majority of belches originates from the stomach. However, in some patients
the eructated air does not originate from the stomach but is sucked or injected
in the esophagus from the pharynx and expelled immediately afterwards in oral
direction. This behavior is called supragastric belching because the air does
not originate from the stomach and does not reach the stomach either1.
Supragastric belches are, in contrast to gastric belches, under voluntary
control.
We recently observed that in a small group of GERD patients supragastric
belches occur in close temporal relation with gastroesophageal reflux
episodes2. Supragastric belches could either immediately precede a liquid
reflux episode (<1s) or occur during a liquid reflux episode. It is currently
not known whether supragastric belches induce reflux episodes or occur in
response to reflux episodes. If, however, these episodes are studied in more
detail, the pathophysiological mechanism underlying these episodes could be
unraveled.
The lower esophageal sphincter is located between the stomach and the
esophagus. Under normal circumstances, the pressure in the lower esophageal
sphincter exceeds gastric pressure. This prevents flow between stomach and
esophagus, thereby preventing gastroesophageal reflux episodes. However,
gastroesophageal reflux episodes can occur during short relaxations of LES
pressure, also known as TLESRs or during an increase in gastric pressure which
exceeds the pressure in the LES, also known as straining3. High resolution
manometry (HRM) is a relatively new method to investigate esophageal and
gastric pressure and the properties of the lower esophageal sphincter (LES) in
detail4. Esophageal impedance monitoring is a technique that can be used to
detect supragastric belches and reflux episodes. These techniques can be
combined to investigate the association between supragastric belches and reflux
episodes and the mechanisms at play5.
We hypothesize that an increased intragastric pressure following a supragastric
belch can result in a gastroesophageal reflux episode. Furthermore, a
relaxation of the lower esophageal sphincter following a supragastric belch can
result in a gastroesophageal reflux episode.
Study objective
We aim to investigate the association between reflux episodes and supragastric
belches using the technique of combined HRM and impedance monitoring.
Study design
A prospective study using combined high-resolution manometry and impedance
measurements.
Study burden and risks
Patients have to travel to the AMC. There are no known risks associated
with these investigations.
Meibergdreef 9
1105 AZ Amsterdam
NL
Meibergdreef 9
1105 AZ Amsterdam
NL
Listed location countries
Age
Inclusion criteria
>10 supragastric belches preceding reflux episodes
Exclusion criteria
Disorders or medication which can influence GI motility
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL37304.018.11 |