Aspiration of even a small amount of a neutral-pH refluxate
causes cough," Koufman explains.
2) LPR is linked to globus by two main mechanisms: (1) vagal reflux stimulation in the esophagus by acidic reflux and (2) mucosal injury in the larynx from direct contact with refluxate
that contains gastric acid and pepsin.
While many people experience some degree of normal reflux of gastric acid contents, such episodes are generally considered "physiologic," as they are asymptomatic and the refluxate
MII with pH sensor allows the detection of acidic (pH<4), weakly acidic (4[greater than or equal to]pH<7), and weakly alkaline (pH[greater than or equal to]7) reflux and can also determine the characteristics of the gastric refluxate
(gas, liquid, mixed gas and liquid).
The nature and amount of refluxed material, as well as the length of time the refluxate
remains in contact with the esophageal mucosa, determine whether disease develops.
Poor esophageal peristalsis may further impair clearance of acid or non-acid refluxate
, thereby explaining the persistence of symptoms despite maximal medical management.
This study was carried out to evaluate the effect of preanaesthetic oral administration of sodium rabeprazole on pH and volume of gastric contents in adult patients undergoing elective surgery by excluding cases contaminated with duodeno-gastric refluxate
These medications decrease acid content and protect the esophagus from chronic irritation caused from the refluxate
Pathologic reflux occurs when the refluxate
overcomes the antireflux barriers.
For acid GER, the proximal extent of the refluxate
is considered to be risk factor for symptom generation in patients with GERD (Weusten and others 1995).
Elevate the head of your bed by six to eight inches or sleep on a wedge pillow to aid gravity to clear the acid refluxate
back into the stomach.
The most commonly used therapies for the treatment of GERD are based on reducing acid secretion, thereby reducing the damaging effect of the gastroesophageal refluxate