| Autor: |
Clarke, Alan T. |
| Rok vydání: |
2011 |
| Předmět: |
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| Druh dokumentu: |
Electronic Thesis or Dissertation |
| Popis: |
The first chapter of my thesis “The Gastro-oesophageal Junction” discusses the histology of the gastro-oesophageal junction and the components integral to the function of the anti-reflux barrier. It also discusses the pathology found at the gastro-oesophageal junction and describes the nitrite chemistry in this region thought to contribute to this pathology. The second chapter “Mechanisms of Gastro-oesophageal Reflux” discusses the mechanisms of gastro-oesophageal reflux. This includes factors that reduce lower oesophageal pressure, the role of the hiatal hernia and the contribution of transient lower oesophageal sphincter relaxations. The relationship between obesity and reflux disease is also discussed. The third chapter “Research into the Nature of the Acid Pocket” details previous research into the nature of the acid pocket, the primary focus of my own studies. The fourth chapter “Severe Reflux Disease is Associated with Enlarged Unbuffered Proximal Gastric Acid Pocket” details my studies comparing the postprandial acid pocket in healthy subjects and patients with severe reflux disease and my attempt to define its position relative to anatomical and manometric landmarks. 12 healthy subjects and 16 patients with severe reflux disease were studied. While fasted, a station pull-through was performed using a combined dual pH and manometry catheter. Position was confirmed by radiological visualisation of endoscopically-placed radio-opaque clips. The pullthrough study was repeated 15 minutes after a standardized fatty meal. Barium meal examination was performed before and following the meal. A region of unbuffered acid (pH≤2) immediately distal to the proximal gastric folds was more frequent in reflux patients (23/32 studies) than in healthy subjects (11/24) (p39.%) (p |
| Databáze: |
Networked Digital Library of Theses & Dissertations |
| Externí odkaz: |
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