{"corpus_id":45268281,"paper_sha":"42d76836e37a0d77b70606f82e39e14e71427f5a","doi":"10.1172/JCI109667","arxiv_id":null,"pmid":7356677,"pmcid":"PMC371362","mag_id":2086960999,"dblp_id":null,"acl_id":null,"title":"Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects.","year":1980,"publication_date":"1980-02-01","venue":"Journal of Clinical Investigation","journal":{"name":"The Journal of clinical investigation","pages":"\n          256-67\n        ","volume":"65 2"},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle","Study"],"pubmed_pub_types":["Comparative Study","Journal Article","Research Support, U.S. Gov't, P.H.S."],"s2_fields_of_study":["Medicine"],"reference_count":26,"citation_count":950,"influential_citation_count":28,"is_open_access":true,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Adult","mj":false,"ui":"D000328"},{"d":"Deglutition","mj":false,"ui":"D003679"},{"d":"Esophagogastric Junction","mj":false,"qs":[{"q":"physiopathology","mj":true,"ui":"Q000503"}],"ui":"D004943"},{"d":"Gastroesophageal Reflux","mj":false,"qs":[{"q":"etiology","mj":true,"ui":"Q000209"},{"q":"physiopathology","mj":false,"ui":"Q000503"}],"ui":"D005764"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Hydrogen-Ion Concentration","mj":false,"ui":"D006863"},{"d":"Peristalsis","mj":false,"ui":"D010528"},{"d":"Posture","mj":false,"ui":"D011187"},{"d":"Pressure","mj":false,"ui":"D011312"},{"d":"Sleep Stages","mj":false,"ui":"D012894"}],"chemicals":null,"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":"http://www.jci.org/articles/view/109667/files/pdf","s2_open_access_landing_url":"https://www.semanticscholar.org/paper/42d76836e37a0d77b70606f82e39e14e71427f5a","s2_open_access_license":null,"s2_open_access_status":"BRONZE","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 investigated the mechanism of gastroesophageal reflux (GER) in 10 health volunteer subjects. Continuous recordings of intraluminal esophageal pH and pressure were obtained on two consecutive nights from 6:00 p.m. to 6:30 a.m. in each subject. During each study, the subject remained recumbent, except to eat a standardized meal after 1 h of basal recording. A manometric assembly with seven recording lumens monitored: (a) lower esophageal sphincter (LES) pressure via a sleeve device 6.5 cm in length, (b) esophageal-body motor activity, (c) swallowing activity in the pharynx, and (d) gastric pressure. An electrode 5 cm above the LES recorded esophageal pH. Sleep was monitored by electroencephalogram. All subjects showed wide variations of basal LES pressure. GER was not related to low steady-state basal LES pressure, but rather occurred during transient 5-30 s episodes of inappropriate complete LES relaxation. The inappropriate LES relaxations were usually either spontaneous or immediately followed appropriate sphincter relaxation induced by swallowing. The majority of GER episodes occurred within the first 3 h after eating. During the night LES relaxation and GER occurred only during transient arousals from sleep or when the subjects were fully awake, but not during stable sleep. After GER the esophagus was generally cleared of refluxed acid by primary peristalsis and less frequently by secondary peristalsis. Nonperistaltic contractions were less effective than peristalsis for clearing acid from the esophagus. We conclude that in asymptomatic recumbent subjects GER is related to transient inappropriate LES relaxations rather than to low steady-state basal LES pressure and also, that primary perstalsis is the major mechanism that clears the esophagus of refluxed material.","claims":[{"public_id":"cl_ed893007e21a32a494b7d27bdce30999","status":"active","text":"Gastroesophageal reflux in recumbent asymptomatic subjects is associated with transient inappropriate complete lower esophageal sphincter relaxations rather than with low steady-state basal lower esophageal sphincter pressure.","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_ed893007e21a32a494b7d27bdce30999"},{"public_id":"cl_c9196b8f60af7908061f4c657474de7c","status":"active","text":"Most reflux episodes occurred within the first 3 hours after eating.","confidence":0.89,"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_c9196b8f60af7908061f4c657474de7c"},{"public_id":"cl_3a939e78024cf54e22d31a022b841648","status":"active","text":"Nighttime lower esophageal sphincter relaxation and reflux occurred only during transient arousals or wakefulness, not during stable sleep.","confidence":0.95,"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_3a939e78024cf54e22d31a022b841648"},{"public_id":"cl_ceb782837d31df16f213398fd17099db","status":"active","text":"Primary peristalsis was the major mechanism clearing refluxed acid from the esophagus, while secondary peristalsis was less frequent and nonperistaltic contractions were less effective.","confidence":0.97,"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_ceb782837d31df16f213398fd17099db"},{"public_id":"cl_e6779b2d8de63829fe8fcd0e840ee126","status":"active","text":"The inappropriate lower esophageal sphincter relaxations were usually spontaneous or occurred immediately after swallowing-induced sphincter relaxation.","confidence":0.9,"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_e6779b2d8de63829fe8fcd0e840ee126"}],"concepts":[{"public_id":"co_180ee157ce9601f03d44910b86acad5d","status":"active","name":"gastroesophageal reflux","description":"The backward flow of gastric contents into the 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