{"corpus_id":36825121,"paper_sha":"c54af35db1c8ac001e8a063d664e4f16c482c4f0","doi":"10.1056/NEJM198212163072503","arxiv_id":null,"pmid":7144836,"pmcid":null,"mag_id":2038438852,"dblp_id":null,"acl_id":null,"title":"Mechanisms of gastroesophageal reflux in patients with reflux esophagitis.","year":1982,"publication_date":"1982-12-16","venue":"New England Journal of Medicine","journal":{"name":"The New England journal of medicine","pages":"\n          1547-52\n        ","volume":"307 25"},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle"],"pubmed_pub_types":["Journal Article","Research Support, U.S. Gov't, P.H.S."],"s2_fields_of_study":["Medicine"],"reference_count":20,"citation_count":996,"influential_citation_count":22,"is_open_access":false,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Adult","mj":false,"ui":"D000328"},{"d":"Esophagitis, Peptic","mj":false,"qs":[{"q":"physiopathology","mj":true,"ui":"Q000503"}],"ui":"D004942"},{"d":"Esophagogastric Junction","mj":false,"qs":[{"q":"physiopathology","mj":true,"ui":"Q000503"}],"ui":"D004943"},{"d":"Female","mj":false,"ui":"D005260"},{"d":"Gastroesophageal Reflux","mj":false,"qs":[{"q":"physiopathology","mj":true,"ui":"Q000503"}],"ui":"D005764"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Hydrogen-Ion Concentration","mj":false,"ui":"D006863"},{"d":"Male","mj":false,"ui":"D008297"},{"d":"Manometry","mj":false,"ui":"D008365"},{"d":"Movement","mj":false,"ui":"D009068"},{"d":"Muscle Relaxation","mj":false,"ui":"D009126"},{"d":"Pressure","mj":false,"ui":"D011312"}],"chemicals":null,"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":null,"s2_open_access_landing_url":null,"s2_open_access_license":null,"s2_open_access_status":null,"pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"We evaluated the mechanisms of gastroesophageal reflux in 10 patients with reflux esophagitis and compared the results with findings from 10 controls. The patients had more episodes of reflux (35 +/- 15 in 12 hours, as compared with 9 +/- 8 in the controls) and a lower pressure of the lower esophageal sphincter (13 +/- 8 mm Hg as compared with 29 +/- 9 in the controls) (P less than 0.001). Reflux occurred by three different mechanisms: transient complete relaxation of the lower esophageal sphincter, a transient increase in intra-abdominal pressure, or spontaneous free reflux associated with a low resting pressure of the lower esophageal sphincter. In controls 94 per cent of reflux episodes were caused by transient sphincter sphincter relaxation. In the patients 65 per cent of episodes of reflux accompanied transient sphincter relaxation, 17 per cent accompanied a transient increase in intra-abdominal pressure, and 18 per cent occurred as spontaneous free reflux. The predominant reflux mechanism in individual patients varied: some had normal resting sphincter pressure and reflux that occurred primarily during transient sphincter relaxation, whereas others with low resting sphincter pressures had spontaneous free reflux or reflux that occurred during an increase in intra-abdominal pressure.","claims":[{"public_id":"cl_59fb8e287ac95832e848ed92e21f0be5","status":"active","text":"Gastroesophageal reflux occurred through three mechanisms: transient complete relaxation of the lower esophageal sphincter, transient increases in intra-abdominal pressure, and spontaneous free reflux associated with low resting lower esophageal sphincter pressure.","confidence":0.99,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous 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(12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_571ee587f3968344c8d21bfd389b4432"},{"public_id":"cl_d1fd3d554b545aee21df87c9a4e8395a","status":"active","text":"Patients with reflux esophagitis had more reflux episodes and lower lower esophageal sphincter pressure than controls.","confidence":0.98,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_d1fd3d554b545aee21df87c9a4e8395a"}],"concepts":[{"public_id":"co_2e630c14045aee755d29d8b5a460abe8","status":"active","name":"spontaneous free reflux","description":"Reflux occurring without a preceding sphincter relaxation event, typically when resting sphincter pressure is low.","types":["mechanism","phenomenon"],"aliases":["free reflux"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous 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