Abstract
Previous studies in our lab have shown that the crural diaphragm contributes to the high pressure zone (HPZ) at the GE junction and relaxes in response to swallowing. The purpose of this study was to determine if crural contraction affects the integrity of the antireflux barrier. Anesthetized cats breathed spontaneously following bilateral cervical phrenicectomy. The effect of increasing electrical stimulation of crural diaphragm using surgically placed bipolar electrodes was measured on a) HPZ pressure measured by a perfused intraluminal manometric assembly and b) gastric volume and pressure required to induce a drop in intra-esophageal pH following rapid gastric perfusion of HCl (pH=4) retrograde through a duodenostomy tube.
RESULTS in 10 cats:
CONCLUSIONS: (1) Electrical stimulation of the crural diaphragm results in a voltage dependent increase in HPZ pressure. (2) A significant voltage dependent increase in gastric volume and pressure is required to induce gastroesophageal reflux during the electrical stimulation of the crural diaphragm. These results suggest a role for active crural contraction in the anti-reflux barrier at the GE junction.
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Altsehuler, S., Nixon, T., Boyle, J. et al. 608 CRURAL DIAPHRAGMATIC CONTRACTION: A COMPONENT OF THE GASTROESOPHAGEAL (GE) ANTIREFLUX MECHANISM. Pediatr Res 19, 212 (1985). https://doi.org/10.1203/00006450-198504000-00638
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DOI: https://doi.org/10.1203/00006450-198504000-00638