Effect of sleep position on nocturnal acid reflux

Effect of sleep position on nocturnal acid reflux

April Esophageal, Gastric, and Duodenal Disorders A167 1998 The volume and pH of the gastric aspirate were measured. At the end of the study, the s...

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April

Esophageal, Gastric, and Duodenal Disorders A167

1998

The volume and pH of the gastric aspirate were measured. At the end of the study, the stomach was removed and opened. The proliferative activity was assessed flowcytometric methods. Light microscopy showed no difference between saline, HCI and Coca Cola groups. The cell cycle analysis showed that the effects of Coca Cola and 0,1N HCI on gastric mucosa were similar. The results of flowcytometric analyses were as follow: G0/GI: 64,7 -+ 2,8, G2/M: 2,3 -+ 1,1, S:32,9 -+ 2,9, PI: 0,4 -+ 1,0 in Coca Cola group; and G0/GI: 52,4 -+ 3, G2/M: 2,1 -+0,9, S: 45,4 -+ 2,9, PI 0,5 -+ 1,0 in HC1 group, and G0/GI: 76,9 -+ 1,8, G2/M:2,4 -+0,4, S: 20,7 -+ 1,9, PI: 0,2 -+0,1 in the control group. G0/G1 and G2/M phases were lower (p < 0,001) and S and PI phases were higher in Cola group than the control group (p < 0,0001). The data showed that Coca Cola and 0,1 N HC1 had similar proliferative and regenerative effects on gastric mucosa. It is possible that their regenerative effects were caused as result of an irritant effect of Cola on gastric mucosa. Control Go/G1 76,9 -+ 1,8 G2/M 2,4 -+0,4 S 20,7 -+ 1,9 PI 0,2 -+ 0,1 * p < 0,0001; ** p < 0,001 difference

0,1 N HCI 52,4 -+3** 2,1 -+0,9** 45,4 -+ 2,9* 0,5 -+ 1" from control

Coca-Cola 64,7 -+2,8** 2,3 -+ 1,1"* 32,9 -+2,9* 0,4 -+ 1"

G0682

RELATIONSHIP BETWEEN HELICOBACTER PYLORI AND OPHTHALMOLOGIC ALTERATIONS. Kapicio~lu Z, Baki AH, Aydin F, Arslan M, Cihanyurdu N, Reis A, Black Sea Technical University School of Medicine, Depts. of Ophthalmology, Microbiology, Pathology and Internal Medicine Section of Gastroenterology. Trabzon - Turkey The recent recognition of Helicobacter pylori (HP) - associated with gastritis is a common pathogenic denominator for a diverse array of gastroduodenal diseases. Specific humoral and cell-mediated responses occur in HP infection. Ophthalmological complications frequently coexist with parasitic infections in humans. Nevertheless the connection between HP and ocular alterations have not been investigated yet. From this point of view, we designed this study to investigate whether there was an association or not between HP and ophthalmological abnormalities. Thirty-seven subjects participated in the study. All had a HP infection verified by an histologic examination, all subjects screened for other parasitic diseases. An ophthalmological examination was done just after HP was diagnosed. The serum samples were examined for HP antibodies in 27 of 31 cases. HP antibodies in the serum samples were determined by enzyme immunoassay. In seven subjects the IgA antibodies of Helicobacteri pylori were positive. HP was positive in 5 patients (20%) and negative in 2 patients (28.5%). The IgG antibodies of Helicobacteri pylori, obtained from 24 subjects, were positive. Among these 20 were HP positive (100%) and 4 were HP negative (57%) (p < 0.01). There were positive correlations between IgG antibodies and a HP infection. None of the subjects had any ophthalmological manifestation. The results showed that there is no relationship between a HP infection and ocular diseases. G0683

THE INHIBITORY EFFECT OF COLA ON GASTRIC MUCOSAL CELL CYCLE PROLIFERATION IN HUMAN. Kapicioglu S, Baki AH, Tekelioglu Y, Arslan M, San M, Ovali E. Black Sea Technical University, School of Medicine, Department of Internal Medicine, Section of Gastroenterology, Pathology Trabzon-TURKEY Acidic beverages may effect the regulation of cell proliferation in the gastric mucosa. Therefore, we analyzed the influence of Coca Cola on gastric mucosa. Sixteen healthy students agreed to participate in this study. An oesophagogastroduodenoscopy was performed all of the volunteers after a 12 hour overnight fast. The endoscopical changes in the gastric mucosa was determined. One day later, after a 12 hours overnight fast, all volunteers received standard Coca Cola (200 ml pH:2,6 4°C). One hour later after drinking Cola, gastric mucosal damage was determined by endoscopy. At least four biopsies from antrum were taken during both first and second endoscopy for flowcytometric analysis. Endoscopic analyses of gastric mucosa showed that there was no difference before and after Coca Cola consumption. The results of flowcytometric analyses were Go/G1:59.4 -+ 0.6, G2/M: 0.6-+0.1, S: 40-+0.7, PI: 0.4+0.1 before Coca Cola, and Go/GI: 69.7+_0.6, G2/M: 1.7+0.2, S: 28.7-+0.5, PI: 0.3-+0.1 after Coca Cola consumption. Coca Cola inhibited proliferation index in S phase. The Go/Gl and G2/M phases were found to be significantly elevated (p < 0.0001,0.0003), and the S and PI phases were found to be significantly lowered after Cola drinking compared with the pre-consumption (p < 0.0002,0.0001). The cell cycle analyses reflect that Coca Cola inhibits a crucial event in the cell cycle occuring a the G1/S border.

Before

After

G0/Gl

59.4 _ 0.6

69.7 -+-0.6*

G2/M

0.6 -+0.1

1.0 -+0.2**

S

40 -+0.7

28.7 -+ 0.5***

PI

0.4-+0.1

0.3-+0.1"

p < 0.0001; ***p < 0.0002; ** p < 0.0003 between two groups G0684

THE RELATIONSHIP BETWEEN HELICOBACTER PYLORI INFECTION AND BRONCHIAL ASTHMA, Kanicio~lu S, Baki AH, 0zlti T, Aydin F, Btilbiil Y, Cihanyurdu N, Arslan M, Black Sea Technical University, School of Medicine, Dept. of Internal Medicine, Section of Gastroenterology, Depts. of Chest Medicine and Microbiology TrabzonTURKEY Bronchial asthma is an allergic disease with Ig E mediated reactions. Some parasitic infections may predispose to the disease. Helicobacter pylori (HP) is an infection that causes gastroduodenal diseases. HP is also supposed to be related with reflux esophagitis reported frequently in the asthmatic patients that produces both local and systemic humoral immunity. Increased Ig A, G, and E serum levels were seen in HP infection. In this study, possible relationship between HP infection and bronchial asthma was investigated. 36 asthmatic patients were enrolled in the study (male/female, 9/27 and a range of age from 21 to 67). Gastroscopic biopsy was taken in all cases. HP was identified by microbiologic culture and Warthin-Starry staining. The patients were examined for reflux esophagitis and gastritis by endoscopy and histopathology. Ig A and G antibodies against HP were also analyzed. HP was isolated from 27 of 36 patient (75%). The distribution of patients according to other examined parameters of the HP infected and uninfected cases were as follows: reflux esophagitis 33.3%, 8.3%; gastritis 55.5%, 13.8%; dyspepsi 47.2%, 11.1%; patients have peak expiratory flow (PEF) < 60% predicted 47.2, 11.1%; patients have symptom score > 2 38.8%, 13.8% respectively. The total Ig E levels and duration of disease of patients were found similar between the both groups. No significant difference was found between HP infected and non-infected patients. HP specific IgG antibody positive in the sera of 23 (63,8%) and IgA antibody positive in the sera of 11 (30,5%) patients respectively. These findings indicated that there is no relationship between HP infection and bronchial asthma. G0685

EFFECT OF SLEEP POSITION ON NOCTURNAL ACID REFLUX. _K_ Kanur. N Tmdgill, L Smith, D Taylor and S Riley. Northern General Hospital, Herries Road, Sheffield, U.K. Background: Nocturnal oesophageal acid exposure is frequently found in patients with severe and/or complicated reflux disease. Since post-prandial reflux is influenced by posture, we have examined the relationship between sleep position and noctumal acid reflux. Methods: Seventeen patients with symptomatic reflux and supine oesophageal acid exposure were studied (11 male, aged 27-72 years). Patients underwent overnight pH study with a position sensor attached to the front of the chest. The sensor comprises two tilt switches which produce different voltages in the supine, fight lateral, left lateral and prone positions. Results: As expected, patients changed sleep position frequently. Patients slept more in the supine and fight lateral positions but intersubject variability was marked (supine 45.2(5.2-89.3)%, fight 33(0-61.7)%, left 17.3(0-53.9)%, prone 1.0(0-10.8)%). Reflux episodes were more frequent in the fight lateral 0.9(0-3.8)/hr and supine positions 0.6(0-3.4)/hr than when the patients were left lateral 0(0-2.7)/hr or prone 0(0-8.1)/hr. Furthermore, the duration of reflux episodes was greater in the right lateral position (right 1.5(0-70)min, supine 0.8(0-39)min, left 0(0-42)min, prone 0(0-0.3)min). Total acid exposure was thus greatest in the right lateral 2.3(0-42.5)min/hr and supine positions 0.9(0-26)min/hr (right vs supine, p=0.17), less in the left lateral position 0(029)min/hr (right vs left, p=0.04) and minimal when prone 0(0-3.4)min/hr (right vs prone, p=0.007). The onset of reflux was frequently related to changes in sleep position (41% of reflux episodes were preceded by a change in sleep position in the minute prior to the episode). Conclusions: Nocturnal reflux occurs more frequently in the fight lateral and supine positions. Reflux episodes are frequently preceded by a change in position. Manipulating sleep position may be of benefit to patients with nocturnal acid reflux.