EFFECT OF LUMBAR ORTHESES WITH ABDOMINAL COMPRESSION ON GASTROESOPHAGEAL REFLUX AND GASTROINTESTINAL TRANSIT

Objective: To investigate the effect of lumbar ortheses with abdominal compression on gastro-oesophageal reflux and gastrointestinal transit . Patients and methods: In a prospective study 20 consecutive patients with lumbar syndrome treated with lumbar orthesis (10 female, 10 male , median age 54.6 years) were investigated for gastro-oesophageal refl ux, mouth-to-cecum transit time (MCT), and whole-gut transit time. Gas tro-oesophageal reflux was assessed performing an ambulatory pH meteri ng of the distal oesophagus over a period of 10 h with and without ort heses on two separate study days. After positioning of the pH catheter patients ingested a liquid-solid test meal labelled with 10 g lactulo se and 750 g indigocarmine to determine MCT with the hydrogen breath t est and whole-gut transit by the first appearance of indigocarmine in the stool. Dyspepsia was assessed by using a standardized questionnair e. Results: Lumbar ortheses induced a significant increase in reflux t ime (pH < 4) (8.1 vs 4.1%), total number of reflux episodes (102.5 vs 69.5) and duration of longest reflux episode (6.0 vs 3.7 min) (P < 0.0 5). 12 patients with ortheses revealed an increase in relative reflux time (2.1 - 24.5%, median: 8.2%) more than two standard deviations com pared to previously obtained normal values. In these patients during o rtheses dyspeptic symptoms correlated significantly with reflux time ( r = 0.6; P < 0.05). In contrast, MCT and whole-gut transit time in pat ients with and without ortheses did not differ significantly (85 vs 85 min; 10.2 vs 9.6 h). Conclusion: Lumbar ortheses with abdominal compr ession, nowadays frequently used in the lumbar syndrome, produce gastr o-oesophageal reflux associated with dyspepsia. Gastrointestinal trans it time is not affected, though.