Siegel and Hendrix (1963) showed that all patients with heartburn developed symptoms with acid perfusion of the oesophagus. Manometric studies performed during perfusion demonstrated one of the following types of motor abnormality: (1) increased amplitude and duration of peristalsis; (2) spastic non-peristaltic contraction; and (3) increased tone. A practical modification of this investigation ...

Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for G...

Results of continuous 12 hour overnight pH monitoring (duration of pH less than 4) were reviewed in 112 patients with heartburn or regurgitation, or both, and in 56 normal subjects. Patients had more reflux than normal subjects. Medically controlled patients (n = 51) had less acid reflux than patients who subsequently underwent reflux surgery (n = 61), but there was a considerable overlap betwe...

Gastroesophageal reflux is a very common disease. Almost everybody experiences heartburn from time to time but with different degree of severity. How does reflux occur, and which factors encourage or work against reflux is a very controversial matter. This article covers all controversial issues about the pathophysiology of gastroesophageal reflux and discusses the old and recent understanding ...