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Japanese

Pathophysiology of Reflux Esophagitis: Role of Gastric and Duodenal Factors Katsuhiko Iwakiri 1 , Toshiaki Sugiura 1 , Makoto Kotoyori 1 1The Third Department of Internal Medicine, Nippon Medical School Keyword: 逆流性食道炎 , 胃伸展拡張刺激 , 胃排出能 , 胃液 , Helicobacter pylori pp.995-999
Published Date 1999/7/25
DOI https://doi.org/10.11477/mf.1403102775
  • Abstract
  • Look Inside

 Transient lower esophageal sphincter (LES) relaxation is the single most common mechanism underlying gastroesophageal reflux. The most important gastric factor affecting the occurrence of transient LES relaxation is gastric distention. Delayed gastric emptying also indirectly promotes gastric distention, and stimulates transient LES relaxation.

 There was no difference between acid output in patients with reflux esophagitis and controls. The major factors causing esophageal damage to the esophagus appear to be acid and pepsin or, under alkaline conditions, trypsin. In addition, the presence of a high concentration of bile acids (more than 0.2 mM) under strong acidic conditions (pH 1.0) in the esophagus probably has an important potentiating influence. However, concentration of bile acids and acid is not likely to be high in the postprandial period.

 It remains unclear whether a considerable proportion of patients treated for Helicobacter pylori will develop reflux esophagitis.


Copyright © 1999, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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