OBJECTIVES: Transient lower esophageal sphincter relaxations (TLESRs) are the major mechanism permitting not only @entity354 but also venting of air from the stomach. Triggering of TLESRs is provoked by @entity356 . Antireflux surgery is associated with impaired ability to belch. It is not known whether a reduced capacity to belch results from postoperative reduction in TLESRs. METHODS: We studied the occurrence of TLESRs, common @entity6675 (indicator for gas @entity354 ), and belching after standardized acute @entity356 by air insufflation (750 ml). Control subjects (n = 10), @entity1 with @entity354 ( @entity354 ) (n = 22), and @entity1 after fundoplication (n = 24) were studied. LES and esophageal motilities were recorded with perfusion manometry. RESULTS: Gastric distension with air significantly (p < 0.05) increased TLESR frequency in controls (1.6+/-0.3 to 3.5+/-1.0 per 20 min), @entity354 @entity1 (1.2+/-0.3 to 3.1+/-0.5 per 20 min), and @entity1 after fundoplication (0.5+/-0.1 to 1.8+/-0.6 per 20 min). Postfundoplication the number of TLESRs was significantly reduced (p < 0.05) both under fasting conditions and after air insufflation. The number of common @entity6675 and belches after gastric air distension also was significantly reduced (p < 0.05) after fundoplication: 2.3+/-0.6 versus 4.7+/-0.4 in controls and 4.1+/-0.4 in @entity354 @entity1 . About half of the common @entity6675 occurred during TLESRs, and half during other mechanisms. An impaired ability to belch in daily life correlated with an impaired belching response during the test. An impaired ability to belch occurred only in @entity1 with complete fundoplication and not in @entity1 with partial fundoplication and was associated with a reduced number of common @entity6675 after gastric air insufflation. CONCLUSIONS: Short-lasting gastric air distension 1) provokes TLESRs but does not differentiate @entity354 @entity1 from controls, 2) reveals impaired belching capacity in @entity1 after complete fundoplication, and 3) shows that common @entity6675 do not exclusively occur during TLESRs.

Provocation of transient lower esophageal sphincter relaxations by XXXX with air.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity6675 :: ('MESH:D020139', 'Disease') :: ['cavities'] @entity356 :: ('MESH:D013274', 'Disease') :: ['gastric distension'] @entity354 :: ('MESH:D005764', 'Disease') :: ['gastroesophageal reflux', 'gastroesophageal reflux disease', 'GERD']
@entity356 :: (MESH:D013274,Disease) :: ['gastric distension']
