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Intragastric manometric measurements of patients with hiatal hernia: A prospective controlled study

Year 2014, Volume: 5 Issue: 1, 1 - 6, 01.03.2014
https://doi.org/10.5799/ahinjs.01.2014.01.0349

Abstract

Objective: Hiatal hernia is a disorder in which abdominal contents, especially gastroesophageal junction and proximal stomach are displaced through an incompetent esophageal hiatus into mediastinum. Aim of this study is to investigate the relationship betweeen intragastric pressure and incompetent cardioesophageal sphincter and hiatal hernia. Methods: The sample is composed of 81 individuals; 51.9% of which are male (n: 42) and 48.1% of which are female (n: 39) with median age of 42.00. Two groups have been constituted: A control group of healthy volunteers (G1) and a patient group with hiatal hernia (G2). After gastroscopy, all patients and controls underwent gastric and esophageal manometry using a water perfused catheter Results: Mean intragastric pressure was 1,308 mmHg for G1 and, -0,105 mmHg for G2. Mean lower esophageal pressure were 13,143 mmHg and 11,65 mmHg, and upper esophageal pressure were 35,273 mmHg and 27,211 mmHg for G1 and G2, respectively. 24 hour pH metry test revealed 26.8% physiologic gastroesophageal reflux and 73.2% pathologic gastroesophageal reflux in G2. There were statistically significant difference between two groups for mean intragastric pressure (p

References

  • Boeckxstaens GE. The lower oesophageal sphincter. Neurogastroenterol Motil 2005; 17: 13-21.
  • Sidhu SA, Triadafilopoulos G. Neuro-regulation of low- er esophageal sphincter function as treatment for gas- troesophageal reflux disease. World J Gastroenterol 2008;14:985-990.
  • Hyun JJ, Bak YT. Clinical Significance of Hiatal Hernia. Gut and Liver 2011;5:267-277.
  • Marchand P. The anatomy of esophageal hiatus of the diaphragm and the pathogenesis of hiatus herniation. J Thorac Surg 1959;37:81-92.
  • Dean C, Etienne D, Carpentier B, et al. Hiatal hernias. Surg Radiol Anat 2012;34:291-299.
  • Kahrilas PJ. Hiatus hernia causes reflux: fact or fiction? Gullet 1993;3:21-30.
  • Turnbull D, Webber S, Hamnegard CH, et al. İntra- abdominal pressure measurement: validation of in- tragastric pressure as a measure of intra-abdominal pressure. Brit J Anaesth 2007;98:628-623.
  • Balogh Z, Jones F, D’Amours S, et al. Continuous intra- abdominal pressure measurement technique. Am J Surg 2004;188:679-684.
  • Ravishankar N, Hunter J. Measurement of intra-ab- dominal pressure in intensive care units in the United Kingdom: a national postal questionnaire study. Br J Anaesth 2005;94:763-766.
  • Pandolfino JE, El-Serag HB, Zhang Q, et al. Obesi- ty: a challenge to esophagogastric junction integrity. Gastroenterology 2006;130:639-649.
  • Mercer CD, Wren SF, DaCosta LR, et al. Lower esophageal sphincter pressure and gastroesophage- al pressure gradients in excessively obese patients. J Med 1987;18:135–146.
  • Sugerman HJ, DeMaria EJ, Felton WL 3rd, et al. In- creased intra abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri. Neurology 1997;49:507–511.
  • Fass R. The Pathophysiological Mechanisms of GERD in the Obese Patient. Dig Dis Sci 2008;53:2300–2306.
  • El Serag HB, Tran T, Richardson P, et al. Anthropo- metric correlates of intragastric pressure. Scand J Gastroenterol 2006;41:887–91.
  • Vegesna A, Besetty R, Kalra A, et al. Induced open- ing of the gastroesophageal junction occurs at a lower gastric pressure in gerd patients and in hiatal hernia subjects than in normal control subjects. Gastroen- terol Res Pract 2010;2010:857654.
  • Kahrilas PJ, Lin S, Chen J, et al. The effect of hiatus hernia on gastro-oesophageal junction pressure. Gut 1999;44:476-82.
  • Dent J, El Serag HB, Wallander MA, et al. Epidemiol- ogy of gastrooesophageal reflux disease: A system- atic review. Gut 2005;54: 710–717.
  • Holloway RH. The anti-reflux barrier and mechanisms of gastro-oesophageal reflux. Best Pract Res Clin Gastroenterol 2000;14:681–699.
  • van Herwaarden MA, Samsom M, Smout AJ. Excess gastroesophageal reflux in patients with hiatus hernia is caused by mechanisms other than transient LES relaxations. Gastroenterology 2000;119:1439–1446.
  • Ott DJ, Glauser SJ, Ledbetter MS, et al. Asso- ciation of Hiatal Hernia and Gastroesophageal Reflux:Correlation Between Presence and Size of Hi- atal Hernia and 24-hour pH Monitoring of the Esopha- gus.AJR 1995;165:557-559.
  • Ye P, Li ZS, Xu GM, et al. Esophageal motility in pa- tients with sliding hiatal hernia with reflux esophagitis. Chinese Medical Journal 2008;121:898-903.
  • Lord RV, DeMeester SR, Peters JH, et al. Hiatal her- nia, lower esophageal sphincter incompetence, and effectiveness of Nissen fundoplication in the spectrum of gastroesophageal reflux disease. J Gastrointest Surg 2009;13:602-610.

Hiatal Hernili hastalarda intragastrik manometrik ölçümler: Prospektif kontrollü bir çalışma

Year 2014, Volume: 5 Issue: 1, 1 - 6, 01.03.2014
https://doi.org/10.5799/ahinjs.01.2014.01.0349

Abstract

Amaç: Hiatus hernisi, diafragmanın özofageal hiatusdaki anatomik zayıflık ya da defekt nedeniyle intraabdominal organların toraksa çıkışı olarak tanımlanabilir. Bu çalışmanın amacı kardio özofageal yetmezlikli ve hiatal hernili hastaların intragastrik basınç düzeylerini incelemekti. Yöntemler: Çalışmaya 81 hasta dâhil edildi. Hastaların 42 (%51,9)\'si erkek iken 39 (%48,1)\'u bayan idi. Yaş ortalamaları 42 yıl olarak tespit edildi. Hastalardan iki grup oluşturuldu. Bir grup (G1) sağlıklı gönüllü hastalardan oluşur iken, ikinci grup (G2) hiatal herni hali olan hastalardan oluşturuldu. Gastroskopiden sonra, tüm hastalara su perfüzyon sistemli kateter kullanılarak gastrik ve özofageal manometrik ölçümler yapıldı. Bulgular: Ortalama intragastrik basınç düzeyi kontrol grubu için 1,308 mmHg iken, hasta grubu için bu değer -0,105 mmHg olarak ölçüldü. Kontrol grubunda distal özofageal gastrik basınç düzeyi 13,143 mmHg iken hasta grubunda bu oran 11,65 mmHg olarak, üst özofageal sfinkter basınç düzeyi sırayla 35,273 mmHg ve 27,211 mmHg olarak ölçüldü. Hiatal herni hali mevcut olan G2 için yapılan 24 saatlik pH monitörizasyonunda %26,8 hastada, reflü fizyolojik sınırlarda iken %73,2 hastada reflü hali patolojik sınırlarda tespit edildi. Gruplar arası intragastrik ve distal özofageal basınç düzeyleri açısından yapılan ikili karşılaştırmalarda sonuçlar istatistiksel olarak anlamlı idi (p

References

  • Boeckxstaens GE. The lower oesophageal sphincter. Neurogastroenterol Motil 2005; 17: 13-21.
  • Sidhu SA, Triadafilopoulos G. Neuro-regulation of low- er esophageal sphincter function as treatment for gas- troesophageal reflux disease. World J Gastroenterol 2008;14:985-990.
  • Hyun JJ, Bak YT. Clinical Significance of Hiatal Hernia. Gut and Liver 2011;5:267-277.
  • Marchand P. The anatomy of esophageal hiatus of the diaphragm and the pathogenesis of hiatus herniation. J Thorac Surg 1959;37:81-92.
  • Dean C, Etienne D, Carpentier B, et al. Hiatal hernias. Surg Radiol Anat 2012;34:291-299.
  • Kahrilas PJ. Hiatus hernia causes reflux: fact or fiction? Gullet 1993;3:21-30.
  • Turnbull D, Webber S, Hamnegard CH, et al. İntra- abdominal pressure measurement: validation of in- tragastric pressure as a measure of intra-abdominal pressure. Brit J Anaesth 2007;98:628-623.
  • Balogh Z, Jones F, D’Amours S, et al. Continuous intra- abdominal pressure measurement technique. Am J Surg 2004;188:679-684.
  • Ravishankar N, Hunter J. Measurement of intra-ab- dominal pressure in intensive care units in the United Kingdom: a national postal questionnaire study. Br J Anaesth 2005;94:763-766.
  • Pandolfino JE, El-Serag HB, Zhang Q, et al. Obesi- ty: a challenge to esophagogastric junction integrity. Gastroenterology 2006;130:639-649.
  • Mercer CD, Wren SF, DaCosta LR, et al. Lower esophageal sphincter pressure and gastroesophage- al pressure gradients in excessively obese patients. J Med 1987;18:135–146.
  • Sugerman HJ, DeMaria EJ, Felton WL 3rd, et al. In- creased intra abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri. Neurology 1997;49:507–511.
  • Fass R. The Pathophysiological Mechanisms of GERD in the Obese Patient. Dig Dis Sci 2008;53:2300–2306.
  • El Serag HB, Tran T, Richardson P, et al. Anthropo- metric correlates of intragastric pressure. Scand J Gastroenterol 2006;41:887–91.
  • Vegesna A, Besetty R, Kalra A, et al. Induced open- ing of the gastroesophageal junction occurs at a lower gastric pressure in gerd patients and in hiatal hernia subjects than in normal control subjects. Gastroen- terol Res Pract 2010;2010:857654.
  • Kahrilas PJ, Lin S, Chen J, et al. The effect of hiatus hernia on gastro-oesophageal junction pressure. Gut 1999;44:476-82.
  • Dent J, El Serag HB, Wallander MA, et al. Epidemiol- ogy of gastrooesophageal reflux disease: A system- atic review. Gut 2005;54: 710–717.
  • Holloway RH. The anti-reflux barrier and mechanisms of gastro-oesophageal reflux. Best Pract Res Clin Gastroenterol 2000;14:681–699.
  • van Herwaarden MA, Samsom M, Smout AJ. Excess gastroesophageal reflux in patients with hiatus hernia is caused by mechanisms other than transient LES relaxations. Gastroenterology 2000;119:1439–1446.
  • Ott DJ, Glauser SJ, Ledbetter MS, et al. Asso- ciation of Hiatal Hernia and Gastroesophageal Reflux:Correlation Between Presence and Size of Hi- atal Hernia and 24-hour pH Monitoring of the Esopha- gus.AJR 1995;165:557-559.
  • Ye P, Li ZS, Xu GM, et al. Esophageal motility in pa- tients with sliding hiatal hernia with reflux esophagitis. Chinese Medical Journal 2008;121:898-903.
  • Lord RV, DeMeester SR, Peters JH, et al. Hiatal her- nia, lower esophageal sphincter incompetence, and effectiveness of Nissen fundoplication in the spectrum of gastroesophageal reflux disease. J Gastrointest Surg 2009;13:602-610.
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Kemal Peker This is me

Abdullah İnal This is me

Mustafa Emiroğlu This is me

İsmayil Yılmaz This is me

İsmail Demiryılmaz This is me

Arda Işık This is me

Publication Date March 1, 2014
Published in Issue Year 2014 Volume: 5 Issue: 1

Cite

APA Peker, K., İnal, A., Emiroğlu, M., Yılmaz, İ., et al. (2014). Hiatal Hernili hastalarda intragastrik manometrik ölçümler: Prospektif kontrollü bir çalışma. Journal of Clinical and Experimental Investigations, 5(1), 1-6. https://doi.org/10.5799/ahinjs.01.2014.01.0349
AMA Peker K, İnal A, Emiroğlu M, Yılmaz İ, Demiryılmaz İ, Işık A. Hiatal Hernili hastalarda intragastrik manometrik ölçümler: Prospektif kontrollü bir çalışma. J Clin Exp Invest. March 2014;5(1):1-6. doi:10.5799/ahinjs.01.2014.01.0349
Chicago Peker, Kemal, Abdullah İnal, Mustafa Emiroğlu, İsmayil Yılmaz, İsmail Demiryılmaz, and Arda Işık. “Hiatal Hernili Hastalarda Intragastrik Manometrik ölçümler: Prospektif Kontrollü Bir çalışma”. Journal of Clinical and Experimental Investigations 5, no. 1 (March 2014): 1-6. https://doi.org/10.5799/ahinjs.01.2014.01.0349.
EndNote Peker K, İnal A, Emiroğlu M, Yılmaz İ, Demiryılmaz İ, Işık A (March 1, 2014) Hiatal Hernili hastalarda intragastrik manometrik ölçümler: Prospektif kontrollü bir çalışma. Journal of Clinical and Experimental Investigations 5 1 1–6.
IEEE K. Peker, A. İnal, M. Emiroğlu, İ. Yılmaz, İ. Demiryılmaz, and A. Işık, “Hiatal Hernili hastalarda intragastrik manometrik ölçümler: Prospektif kontrollü bir çalışma”, J Clin Exp Invest, vol. 5, no. 1, pp. 1–6, 2014, doi: 10.5799/ahinjs.01.2014.01.0349.
ISNAD Peker, Kemal et al. “Hiatal Hernili Hastalarda Intragastrik Manometrik ölçümler: Prospektif Kontrollü Bir çalışma”. Journal of Clinical and Experimental Investigations 5/1 (March 2014), 1-6. https://doi.org/10.5799/ahinjs.01.2014.01.0349.
JAMA Peker K, İnal A, Emiroğlu M, Yılmaz İ, Demiryılmaz İ, Işık A. Hiatal Hernili hastalarda intragastrik manometrik ölçümler: Prospektif kontrollü bir çalışma. J Clin Exp Invest. 2014;5:1–6.
MLA Peker, Kemal et al. “Hiatal Hernili Hastalarda Intragastrik Manometrik ölçümler: Prospektif Kontrollü Bir çalışma”. Journal of Clinical and Experimental Investigations, vol. 5, no. 1, 2014, pp. 1-6, doi:10.5799/ahinjs.01.2014.01.0349.
Vancouver Peker K, İnal A, Emiroğlu M, Yılmaz İ, Demiryılmaz İ, Işık A. Hiatal Hernili hastalarda intragastrik manometrik ölçümler: Prospektif kontrollü bir çalışma. J Clin Exp Invest. 2014;5(1):1-6.