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Radially asymmetric gastroesophageal acid reflux in the distal esophagus: examinations with novel pH sensor catheter equipped with 8 pH sensors

  • Original Article—Alimentary Tract
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Abstract

Background

Esophageal mucosal breaks in patients with Los Angeles (LA) grade A or B esophagitis are mainly found in the right anterior wall of the distal esophagus. The aim of this study was to reveal radial acid exposure in the distal esophagus and determine whether radial asymmetry of acid exposure is a possible cause of radially asymmetric distribution of the lesions.

Methods

We developed a novel pH sensor catheter using a polyvinyl chloride catheter equipped with 8 antimony pH sensors radially arrayed at the same level. Four healthy volunteers, 5 patients with non-erosive reflux disease (NERD), and 10 with LA grade A or B esophagitis were enrolled. The sensors were set 2 cm above the upper limit of the lower esophageal sphincter, and post-prandial gastroesophageal acid reflux was monitored for 3 h with the subjects in a sitting position.

Results

We successfully examined radial acid exposure in the distal esophagus in all subjects using our novel pH sensor catheter. Radial variations of acid exposure in the distal esophagus were not observed in the healthy subjects. In contrast, the patients with NERD and those with reflux esophagitis had radial asymmetric acid exposure that was predominant on the right wall of the distal esophagus. In the majority of patients with reflux esophagitis, the directions of longer acid exposure coincided with the locations of mucosal breaks.

Conclusions

Radial acid exposure could be examined using our novel 8-channel pH sensor catheter. We found that the directions of longer acid exposure were associated with the locations of mucosal breaks.

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Acknowledgments

This study was supported in part by a grant from the Ministry of Education, Culture, Sports, Science and Technology-Japan (No. 22590683).

Conflict of interest

All authors declare that they have no conflicts of interests or financial interests.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan

    Shunji Ohara, Kenji Furuta, Shino Shimura, Kousuke Fukazawa, Masahito Aimi & Yoshikazu Kinoshita

  2. Department of Clinical Nursing, Shimane University School of Medicine, Izumo, Japan

    Kyoichi Adachi

  3. Division of Internal Medicine, Masuda Red Cross Hospital, Masuda, Japan

    Eisuke Okamoto

  4. Division of Internal Medicine, Izumo-City General Medical Center, Izumo, Japan

    Yoshinori Komazawa

Authors
  1. Shunji Ohara
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  2. Kenji Furuta
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  3. Kyoichi Adachi
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  4. Shino Shimura
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  5. Kousuke Fukazawa
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  6. Masahito Aimi
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  7. Eisuke Okamoto
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  8. Yoshinori Komazawa
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  9. Yoshikazu Kinoshita
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Corresponding author

Correspondence to Kenji Furuta.

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Ohara, S., Furuta, K., Adachi, K. et al. Radially asymmetric gastroesophageal acid reflux in the distal esophagus: examinations with novel pH sensor catheter equipped with 8 pH sensors. J Gastroenterol 47, 1221–1227 (2012). https://doi.org/10.1007/s00535-012-0595-y

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  • DOI: https://doi.org/10.1007/s00535-012-0595-y

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