SIMULTANEOUS ASSESSMENT OF LOWER ESOPHAGE AL SPHINCTER PRESSURE AND GASTRIC TONE IN HEALTHY HUMANS

Objectives. - The aim of this study, was to determine the feasibility and tolerance of simultaneous assessment of the proximal gastric and l ower esophageal sphincter tones in healthy humans, in fasting and fed conditions. Methods. - Esophageal motility and lower esophageal sphinc ter tone were measured on two separate days in 7 healthy subjects. Dur ing one of these sessions, proximal gastric tone was simultaneously as sessed with a balloon placed in the proximal stomach and connected to art electronic barostat. Motility was monitored 1 hour before and 4 ho urs after a liquid fat meal (400 mL / 600 kcal). In four other healthy subjects, simultaneous assessments of proximal gastric and lower esop hageal sphincter tones was performed after ingestion of a 200 mL / 200 kcal liquid meal. Results. - Simultaneous use of gastric barostat and esophageal motility device was well tolerated in 10/11 healthy subjec ts. The presence of the barostat balloon did not significantly, affect basal lon er esophageal sphincter tone and tile rate of transient low er esophageal sphincter relaxations. The important fall of lower esoph ageal sphincter basal tone after ingestion of the 400 mL / 600 kcal me al did not allow to detect a post-prandial increase of transient lower esophageal sphincter relaxations increased After ingestion of tile 20 0 mL / 200 kcal meal, the incidence of transient lower esophageal sphi ncter relaxations increased (p < 0,02 vs. fasting), Maximal gastric re laxation was reached 15 min after meal, and appeared shorter (112 +/- 17 min vs. 167 +/- 24 min) and more pronounced (292 +/- 26 mL vs. 190 +/- 51 mL) than after the 400 mL meal, but differences were not statis tically significant. Conclusions. - Simultaneous assessment of proxima l gastric and lower er esophageal sphincter tone is feasible, after or al ingestion of a meal. Since the 400 mL meal induces an important inh ibition of lower esophageal sphincter basal tone, the 200 mL meal seem s more adequate for assessment of the transient lower esophageal sphin cter relaxations.