4.7 Review

The Acid Pocket: A Target for Treatment in Reflux Disease ?

期刊

AMERICAN JOURNAL OF GASTROENTEROLOGY
卷 108, 期 7, 页码 1058-1064

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1038/ajg.2013.132

关键词

-

资金

  1. EndoGastric Solutions
  2. Ironwood Pharmaceuticals
  3. Reckitt Benckiser
  4. Torax
  5. US National Institute of Health [R01 DC00646]
  6. GSK
  7. Astra Zeneca
  8. MMS
  9. Shire Movetis
  10. Sandhill Scientific
  11. Research Foundation-Flanders (FWO) (Odysseus program) [G.0905.07]
  12. Innovation by Science and Technology (IWT), Belgium
  13. Chief Scientist Office [CZB/4/709] Funding Source: researchfish

向作者/读者索取更多资源

The nadir esophageal pH of reflux observed during pH monitoring in the postprandial period is often more acidic than the concomitant intragastric pH. This paradox prompted the discovery of the acid pocket, an area of unbuffered gastric acid that accumulates in the proximal stomach after meals and serves as the reservoir for acid reflux in healthy individuals and gastroesophageal reflux disease (GERD) patients. However, there are differentiating features between these populations in the size and position of the acid pocket, with GERD patients predisposed to upward migration of the proximal margin onto the esophageal mucosa, particularly when supine. This upward migration of acid, sometimes referred to as an acid film, likely contributes to mucosal pathology in the region of the squamocolumnar junction. Furthermore, movement of the acid pocket itself to a supradiaphragmatic location with hiatus hernia increases the propensity for acid reflux by all conventional mechanisms. Consequently, the acid pocket is an attractive target for GERD therapy. It may be targeted in a global way with proton pump inhibitors that attenuate acid pocket development, or with alginate/antacid combinations that colocalize with the acid pocket and displace it distally, thereby demonstrating the potential for selective targeting of the acid pocket in GERD.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.7
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据