Picture of smart phone in human hand

World leading smartphone and mobile technology research at Strathclyde...

The Strathprints institutional repository is a digital archive of University of Strathclyde's Open Access research outputs. Strathprints provides access to thousands of Open Access research papers by University of Strathclyde researchers, including by Strathclyde researchers from the Department of Computer & Information Sciences involved in researching exciting new applications for mobile and smartphone technology. But the transformative application of mobile technologies is also the focus of research within disciplines as diverse as Electronic & Electrical Engineering, Marketing, Human Resource Management and Biomedical Enginering, among others.

Explore Strathclyde's Open Access research on smartphone technology now...

Kinetics of transient hiatus hernia during transient lower esophageal sphincter relaxations and swallows in healthy subjects

Lee, Y. Y. and Whiting, J. G. H. and Derakhshan, M. H. and Wirz, A. A. and Smith, D. and Morrison, D. and Kelman, A. and Connolly, P. and McColl, K. E. L. and Connolly, Patricia (2012) Kinetics of transient hiatus hernia during transient lower esophageal sphincter relaxations and swallows in healthy subjects. Neurogastroenterology and Motility, 24 (11). pp. 990-999. ISSN 1350-1925

Full text not available in this repository. Request a copy from the Strathclyde author

Abstract

Background Proximal displacement of the gastro-esophageal junction (GEJ) is present in hiatus hernia but also occurs transiently during transient lower esophageal sphincter relaxations (TLESRs) and swallows. Using a novel magnetic-based technique we have performed detailed examination of the GEJ movement during TLESRs and swallows in healthy subjects. Methods In 12 subjects, a magnet was endoscopically clipped to the GEJ and combined assembly of Hall-Effect locator probe and 36 channel high-resolution manometer passed nasally. After a test meal the subjects were studied for 90 min. Key Results The median amplitude of proximal movement of GEJ during TLESRs was 4.3 cm (1.68.8 cm) and this was substantially greater than during swallowing at 1.2 cm (0.42.7 cm), P = 0.002. With both TLESRs and swallows proximal GEJ movement coincided with lower esophageal sphincter (LES) relaxation and return to its original position occurred 4 s after return of LES tone. Kinetic modeling of the movement of the GEJ during TLESRs indicated two return phases with the initial return phase having the greater velocity (0.9 cm s-1) and being strongly correlated with amplitude of proximal movement (r = 0.8, P < 0.001). Conclusions & Inferences The marked proximal GEJ migration during TLESRs represents very severe herniation of the GEJ. The rapid initial return of the GEJ following TLESRs when the crural diaphragm is relaxed and its correlation with amplitude suggest it is due to elastic recoil of the phreno-esophageal ligament. The marked stretching of the phreno-esophageal ligament during TLESRs may contribute to its weakening and development of established hiatus hernia.