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Rationale and Efficacy of Conservative Therapy for Gastroesophageal Reflux Disease

Rationale and Efficacy of Conservative Therapy for Gastroesophageal Reflux Disease Abstract Major recent advances in the diagnosis and understanding of gastroesophageal reflux disease have afforded the practicing clinician a number of therapeutic options to treat the increasingly recognized affected patient population. With highly effective acid-suppressive therapies available, simple life-style modifications, such as selective food and medicine avoidance, weight loss, smoking cessation, elevation of the head of the bed, and the judicious use of antacids and alginate, have been relegated to a minor, if any, role in the management of these patients. The validity of these recommendations, however, remains consistent with our current understanding of the pathogenesis of gastroesophageal reflux disease. Although few well-designed placebo-controlled trials have been conducted, a review of the medical literature indicates an appreciable efficacy of these interventions, which are founded on well-studied physiologic determinants of gastroesophageal reflux. Most patients with gastroesophageal reflux disease can be managed by reassurance and simple life-style adjustments alone. The therapy for those with chronic or relapsing disease should always include the adjunctive reinforcement of these simple, efficacious, and cost-effective measures. (Arch Intern Med. 1991;151:448-454) References 1. Weinbeck M, Barnert J. Epidemiology of reflux disease and reflux esophagitis . Scand J Gastroenterol. 1989;24( (suppl 156) ):7-13.Crossref 2. Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal reflux: incidence and precipitating factors . Am J Dig Dis. 1976;21:953-956.Crossref 3. Graham DY, Smith JL, Patterson DJ. Why do apparently healthy people use antacid tablets? Am J Gastroenterol. 1983;78:257-260. 4. Castell DO. Gastroesophageal reflux: the great imitator . West J Med. 1988;149:81-82. 5. Wiener GJ, Koufman JA, Wu WC, Cooper JB, et al. Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-H ambulatory pH monitoring . Am J Gastroenterol. 1989;84:1503-1508. 6. Allen JC, Newhouse MT. Gastroesophageal reflux and chronic respiratory disease . Am Rev Respir Dis. 1984;129:645-647. 7. Barish CF, Wu WC, Castell DO. Respiratory complications of gastroesophageal reflux . Arch Intern Med. 1985;145:1882-1888.Crossref 8. Winters C, Spurling TJ, Chobanian SJ, et al. Barrett's esophagus . Gastroenterology. 1987;92:118-124. 9. Castell DO, Wu WC, Ott DJ, eds. Gastroesophageal Reflux Disease . Mount Kisco, NY: Futura Publishing Co; 1985:5. 10. Roufail WM. Medical management of patients with reflux esophagitis . South Med J. 1978;71( (suppl 1) ):43-44.Crossref 11. Bennett JR. Medical management of gastro-esophageal reflux . Clin Gastroenterol. 1976;5:175-185. 12. Richter JE. A critical review of current medical therapy for gastroesophageal reflux disease . J Clin Gastroenterol. 1986;8( (suppl 1) ):72-80.Crossref 13. Castell DO. Medical therapy for reflux esophagitis: 1986 and beyond . Ann Intern Med. 1986;194:112-114.Crossref 14. Castell DO. Future medical therapy of reflux esophagitis . J Clin Gastroenterol. 1986;8( (suppl 1) ):81-85.Crossref 15. Johnson LF, DeMeester TR. Twenty-four hour pH monitoring of the distal esophagus . Am J Gastroenterol. 1974;62:325-332. 16. Babka JC, Hager GW, Castell DO. The effect of body position on lower esophagus sphincter pressure . Dig Dis. 1973;18:441-442. Letter.Crossref 17. DeMeester TR, Johnson LF, Joseph GJ, et al. Patterns of gastroesophageal reflux in health and disease . Ann Surg. 1976;184:459-470.Crossref 18. Kjellen G, Tibbling L. Influence of body position, dry and water swallows, smoking, and alcohol on esophageal acid clearing . Scand J Gastroenterol. 1978;13:283-288.Crossref 19. Stanciu C, Bennett JR. Effects of posture on gastro-oesophageal reflux . Digestion. 1977;15:104-109.Crossref 20. Johnson LF, DeMeester TR. Evaluation of elevation of the head of the bed, bethanechol, and antacid foam tablets on gastroesophageal reflux . Dig Dis Sci. 1981;26:673-680.Crossref 21. Hamilton JW, Boisen RJ, Yamamoto DT, et al. Sleeping on a wedge diminishes exposure of the esophagus to refluxed acid . Dig Dis Sci. 1988;33:518-522.Crossref 22. Kleinman M, Plain G. Reflux esophagitis and the waterbed . JAMA. 1987:257:2033.Crossref 23. Wang JC, Castell DO, Sinclair JW, Wu WC. Does sleeping on a waterbed promote gastroesophageal reflux? Dig Dis Sci. 1989;34:1585-1589.Crossref 24. Richter JE, Castell DO. Drugs, foods, and other substances in the cause and treatment of reflux esophagitis . Med Clin North Am. 1981;65:1223-1233. 25. Babka JC, Castell DO. On the genesis of heartburn: the effects of specific foods on the lower esophageal sphincter . Dig Dis. 1973;18:391-397.Crossref 26. Chernow B, Castell DO. Diet and heartburn . JAMA. 1979;241:2307-2308.Crossref 27. Castell DO. Diet and the lower esophageal sphincter . Am J Clin Nutr. 1975;28:1296-1298. 28. Wright LE, Castell DO. The adverse effect of chocolate on lower esophageal sphincter pressure . Dig Dis. 1975;20:703-707.Crossref 29. Murphy DW, Castell DO. Chocolate and heartburn: evidence of increased esophageal acid exposure after chocolate ingestion . Am J Gastroenterol. 1988;83:633-636. 30. Sigmund CJ, McNally EF. The action of a carminative on the lower esophageal sphincter . Gastroenterology. 1969;56:13-18. 31. Allen ML, Mellow MH, Robinson MG, Orr WC. The effect of raw onions on acid reflux and reflux symptoms . Am J Gastroenterol. 1990;85:377-380. 32. Nebel OT, Castell DO. Lower esophageal sphincter pressure changes after food digestion . Gastroenterology. 1972;63:778-783. 33. Becker DJ, Sinclair J, Castell DO, Wu WC. A comparison of high and low fat meals on postprandial esophageal acid exposure . Am J Gastroenterol. 1989;84:782-786. 34. Cohen S. Pathogenesis of coffee-induced gastrointestinal symptoms . N Engl J Med. 1980;303:122-124.Crossref 35. Thomas FB, Steinbaugh JT, Fromkes JJ, et al. Inhibitory effect of coffee on lower esophageal sphincter pressure . Gastroenterology. 1980;79:1262-1266. 36. Salmon PR, Fedail SS, Wurzner HP, et al. Effect of coffee on human lower oesophageal function . Digestion. 1981;21:69-73.Crossref 37. McArthur K, Hogan D, Isenberg JI. Relative stimulatory effects of commonly ingested beverages on gastric acid secretion in humans . Gastroenterology. 1982;83:199-203. 38. Price SF, Smithson KW, Castell DO. Food sensitivity in reflux esophagitis . Gastroenterology. 1978;75:240-243. 39. Lloyd DA, Borda IT. Food-induced heartburn: effect of osmolality . Gastroenterology. 1981;80:740-741. 40. Hogan WJ, Viegas de Andrade SR, Winship DH. Ethanol-induced acute esophageal motor dysfunction . J Appl Physiol. 1972;32:755-760. 41. Vitale G, Cheadle WG, Patel B, et al. The effect of alcohol on nocturnal gastroesophageal reflux . JAMA. 1987;258:2077-2079.Crossref 42. Dennish GW, Castell DO. Inhibitory effect of smoking on the lower esophageal sphincter . N Engl J Med. 1971;284:1136-1137.Crossref 43. Stanciu C, Bennett JR. Smoking and gastro-esophageal reflux . BMJ. 1972;3:793-795.Crossref 44. Kahrilas PJ, Gupta RR. Mechanisms of acid reflux associated with cigarette smoking . Gut. 1990;31:4-10.Crossref 45. Kahrilas PJ, Gupta RR. The effect of smoking on salivation and esophageal acid clearance . J Lab Clin Med . In press. 46. Koelz HR, Birchler R, Bretholz A, et al. Healing and relapse of reflux esophagitis during treatment with ranitidine . Gastroenterology. 1986;91:1198-1205. 47. Berenson MM, Sontag S, Robinson MG, et al. Effect of smoking in a controlled study of ranitidine treatment in gastroesophageal reflux disease . J Clin Gastroenterol. 1987;9:499-503.Crossref 48. Schindlbeck NE, Heinrich C, Dendorfer A, Pace F, Muller-Lissner SA. Influence of smoking and esophageal intubation on esophageal pH-metry . Gastroenterology. 1987;92:1994-1997. 49. Waring JP, Eastwood TF, Austin JM, Sanowski RA. The immediate effects of cessation of cigarette smoking on gastroesophageal reflux . Am J Gastroenterol. 1989;84:1076-1078. 50. Berquist WE, Rachelefsky GS, Kadden M. Effect of theophylline on gastroesophageal reflux in normal adults . J Allergy Clin Immunol. 1981;67:407-411.Crossref 51. Foster LJ, Trudeau WL, Goldman AL. Bronchodilator effects on gastric acid secretion . JAMA. 1979;241:2613-2615.Crossref 52. Ekstrom T, Tibbling L. Influence of theophylline on gastro-oesophageal reflux and asthma . Eur J Clin Pharmacol. 1988;35:353-356.Crossref 53. Haringsma J, Bartelsman JFWM, Tytgat GNJ. Chronic low-dose theophylline has no significant effect on lower esophageal sphincter pressure in healthy volunteers . Gastroenterology. 1989;96:A197. Abstract. 54. Hubert D, Gaudric M, Marsac J, Guerre J. Theophylline does not increase gastroesophageal reflux in asthmatic patients . Am Rev Respir Dis. 1986;133:A320. Abstract. 55. Sontag SJ, O'Connell S, Khandelwall S, et al. Most asthmatics have asthmatic gastroesophageal reflux with or without bronchodilator therapy . Gastroenterology. 1990;99:613-620. 56. Schindlbeck NE, Heinrich C, Huber RM, Muller-Lissner SA. Effects of albuterol on esophageal motility and gastroesophageal reflux in healthy volunteers . JAMA. 1988;260:3156-3158.Crossref 57. Castell DO. The lower esophageal sphincter: physiologic and clinical aspects . Ann Intern Med. 1975;83:390-401.Crossref 58. Richter JE, Dalton CB, Buice RG, Castell DO. Nifedipine: a potent inhibitor of contractions in the body of the esophagus . Gastroenterology. 1985;89:549-554. 59. Van Thiel DH, Gavaler JS, Stremple J. Lower esophageal sphincter pressure in women using sequential oral contraceptives . Gastroenterology. 1976;71:232-234. 60. Bainbridge ET, Nicholas SD, Newton JR, Temple JG. Gastro-oesophageal reflux in pregnancy: altered function of the barrier to reflux in asymptomatic women during early pregnancy . Scand J Gastroenterol. 1984;19:85-89. 61. Van Thiel DH, Gavaler JS, Joshi SN, Sara RK, Stremple J. Heartburn of pregnancy . Gastroenterology. 1977;72:666-668. 62. O'Brien TF. Lower esophageal sphincter pressure and esophageal function in obese humans . J Clin Gastroenterol. 1980;2:145-148.Crossref 63. Hagen J, Deitel M, Khanna K, lives R. Gastroesophageal reflux in the massively obese . Int Surg. 1987;72:1-3. 64. Mercer CD, Wren SF, DaCosta LR, Beck IT. Gastroesophageal pressure gradients and lower esophageal sphincter pressures in severely obese patients . Gastroenterology. 1982;82:1129. Abstract. 65. Dent J. Recent views on the pathogenesis of gastro-oesophageal reflux disease . Baillieres Clin Gastroenterol. 1987;1:727-745.Crossref 66. Schofield PM, Bennett DH, Whorwell PJ, et al. Exertional gastrooesophageal reflux: a mechanism for symptoms in patients with angina pectoris and normal coronary angiograms . BMJ. 1987;294:1459-1461.Crossref 67. Clark CS, Kraus BB, Sinclair J, Castell DO. Gastroesophageal reflux induced by exercise in healthy volunteers . JAMA. 1989;261:3599-3601.Crossref 68. Behar J, Sheahan DG, Biancani P, et al. Medical and surgical management of reflux esophagitis: a 38-month report on a prospective clinical trial . N Engl J Med. 1975;293:263-268.Crossref 69. Lieberman DA. Medical therapy for chronic reflux esophagitis: longterm follow-up . Arch Intern Med. 1987;147:1717-1720.Crossref 70. Malmud LS, Fisher RS. Quantitation of gastroesophageal reflux before and after therapy using the gastroesophageal scintiscan . South Med J. 1978;71 ( (suppl 1) ):10-15.Crossref 71. Orenstein SR, Whitington PF. Positioning for prevention of infant gastroesophageal reflux . J Pediatr. 1983;103:534-537.Crossref 72. Weihrauch TR. Gastro-esophageal reflux: pathogenesis and clinical implications . Eur J Pediatr. 1985;144:215-218.Crossref 73. Harvey RF, Hadley N, Gill TR, et al. Effects of sleeping with the bedhead raised and of ranitidine in patients with severe peptic oesophagitis . Lancet. 1987;2:1200-1203.Crossref 74. Sontag S, Robinson M, McCallum RW, et al. Ranitidine therapy for gastroesophageal reflux disease: results of a large double-blind trial . Arch Intern Med. 1987;147:1485-1491.Crossref 75. Morrissey JF, Barreras RF. Antacid therapy . N Engl J Med. 1974;290:550-554.Crossref 76. Scarpignato C. Pharmacological bases of the medical treatment of gastroesophageal reflux disease . Dig Dis. 1988;6:117-148.Crossref 77. Higgs RH, Smyth RD, Castell DO. Gastric alklanization: effect of loweresophageal sphincter pressure and serum gastrin . N Engl J Med. 1974;291:486-490.Crossref 78. Cucchiara S, Staiano A, Romaniello G, et al. Antacids and cimetidine treatment for gastro-oesophageal reflux and peptic oesophagitis . Arch Dis Child. 1984;59:842-847.Crossref 79. Saco LS, Orlando RC, Levinson SL, et al. Double-blind controlled trial of bethanechol and antacid versus placebo and antacid in the treatment of erosive esophagitis . Gastroenterology. 1982;82:1369-1373. 80. Levi P, Marmo F, Saluzzo C, et al. Bethanechol versus antacids in the treatment of gastroesophageal reflux . Helv Paediatr Acta. 1985;40:349-359. 81. Ogilvie AL, Atkinson M. Does dimethicone increase the efficacy of antacids in the treatment of reflux esophagitis . J R Soc Med. 1986;79:584-587. 82. Hassan SS. Treatment of moderate to severe gastro-esophageal reflux with an alginate/antacid combination . Curr Med Res Opin. 1980;6:645-648.Crossref 83. Williams DL, Haigh GG, Redfern JN. The symptomatic treatment of heartburn and dyspepsia with liquid Gaviscon: a multicentre general practitioner study . J Int Med Res. 1979;7:551-555. 84. Laitinen S, Stahlberg M, Kairaluoma MI, et al. Sucralfate and alginate/antacid in reflux esophagitis . Scand J Gastroenterol. 1985;20:229-232.Crossref 85. Tonneson H, Andersen JR, Christoffersen P, Kaas-Claesson N. Reflux oesophagitis in heavy drinkers: effect of ranitidine and alginate/metoclopramide . Digestion. 1987;38:69-73.Crossref 86. Reed PI, Davies WA. Controlled trial of a new dosage form of carbenoxolone (Pyrogastrone) in the treatment of reflux esophagitis . Dig Dis. 1978;23:161-165.Crossref 87. Young GP, Nagy GS, Myren J, et al. Treatment of reflux oesophagitis with a carbenoxolone/antacid/alginate preparation: a double-blind controlled trial . Scand J Gastroenterol. 1986;21:1098-1104.Crossref 88. Grossman AE, Klotz AP, Rhodes JB, Korb T. Reflux esophagitis: a comparison of old and new medical management . J Kans Med Soc. 1973;>74:423-424. 89. Chevrel B. A comparative crossover study on the treatment of heart-burn and epigastric pain: liquid Gaviscon and a magnesium-aluminum antacid gel . J Int Med Res. 1980;8:300-302. 90. Scobie BA. Endoscopically controlled trial of alginate and antacid in reflux oesophagitis . Med J Aust. 1976;1:627-628. 91. Graham DY, Lanza F, Dorsch ER. Symptomatic reflux esophagitis: a double-blind controlled comparison of antacids and alginate . Curr Ther Res. 1977;22:653-658. 92. McHardy G. A multicentric randomized clinical trial of Gaviscon in reflux esophagitis . South Med J. 1978;71( (suppl 1) ):16-21.Crossref 93. Barnardo DE, Lancaster-Smith M, Strickland ID, Wright JT. A double-blind controlled trial of Gaviscon in patients with symptomatic gastro-oesophageal reflux . Curr Med Res Opin. 1975;3:388-391.Crossref 94. Meyer C, Berenzweig H, Kuljian B, et al. Controlled trial of antacid versus placebo on relief of heartburn . Gastroenterology. 1979;76:1201. Abstract. 95. Furman D, Mensh R, Winan G, et al. A double-blind trial comparing high dose liquid antacid to placebo and cimetidine in improving symptoms and objective parameters in gastroesophageal reflux . Gastroenterology. 1982;82:1062. Abstract. 96. Graham DY, Patterson DJ. Double-blind comparison of liquid antacid and placebo in the treatment of symptomatic reflux esophagitis . Dig Dis Sci. 1983;28:559-563.Crossref 97. Grove O, Bekker C, Jeppe-Hansen MG, et al. Ranitidine and high-dose antacid in reflux oesophagitis: a randomized, placebo-controlled trial . Scand J Gastroenterol. 1985;20:457-461.Crossref 98. Weberg R, Berstad A. Symptomatic effect of a low-dose antacid regimen in reflux oesophagitis . Scand J Gastroenterol. 1989;24:401-406.Crossref 99. Beeley M, Warner JO. Medical treatment of symptomatic hiatus hernia with low-density compounds . Curr Med Res Opin. 1972;1:63-69.Crossref 100. Stanciu C, Bennett JR. Alginate/antacid in the reduction of gastrooesophageal reflux . Lancet. 1974;1:109-111.Crossref 101. Buts JP, Barudi C, Otte JB. Double-blind controlled study on the efficacy of sodium alginate (Gaviscon) in reducing gastroesophageal reflux assessed by 24H continuous pH monitoring in infants and children . Eur J Pediatr. 1987;146:156-158.Crossref 102. Lanza FL, Smith V, Page-Castell JA, Castell DO. Effectiveness of foaming antacid in relieving induced heartburn . South Med J. 1986;79:327-330.Crossref 103. Klauser AG, Heinrich C, Schindlbeck NE, Muller-Lissner SA. Is long-term esophageal pH monitoring of clinical value? Am J Gastroenterol. 1989;84:362-366. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Rationale and Efficacy of Conservative Therapy for Gastroesophageal Reflux Disease

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American Medical Association
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Copyright © 1991 American Medical Association. All Rights Reserved.
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0003-9926
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1538-3679
DOI
10.1001/archinte.1991.00400030018004
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Abstract

Abstract Major recent advances in the diagnosis and understanding of gastroesophageal reflux disease have afforded the practicing clinician a number of therapeutic options to treat the increasingly recognized affected patient population. With highly effective acid-suppressive therapies available, simple life-style modifications, such as selective food and medicine avoidance, weight loss, smoking cessation, elevation of the head of the bed, and the judicious use of antacids and alginate, have been relegated to a minor, if any, role in the management of these patients. The validity of these recommendations, however, remains consistent with our current understanding of the pathogenesis of gastroesophageal reflux disease. Although few well-designed placebo-controlled trials have been conducted, a review of the medical literature indicates an appreciable efficacy of these interventions, which are founded on well-studied physiologic determinants of gastroesophageal reflux. Most patients with gastroesophageal reflux disease can be managed by reassurance and simple life-style adjustments alone. The therapy for those with chronic or relapsing disease should always include the adjunctive reinforcement of these simple, efficacious, and cost-effective measures. (Arch Intern Med. 1991;151:448-454) References 1. Weinbeck M, Barnert J. Epidemiology of reflux disease and reflux esophagitis . Scand J Gastroenterol. 1989;24( (suppl 156) ):7-13.Crossref 2. Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal reflux: incidence and precipitating factors . Am J Dig Dis. 1976;21:953-956.Crossref 3. Graham DY, Smith JL, Patterson DJ. Why do apparently healthy people use antacid tablets? Am J Gastroenterol. 1983;78:257-260. 4. Castell DO. Gastroesophageal reflux: the great imitator . West J Med. 1988;149:81-82. 5. Wiener GJ, Koufman JA, Wu WC, Cooper JB, et al. Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-H ambulatory pH monitoring . Am J Gastroenterol. 1989;84:1503-1508. 6. Allen JC, Newhouse MT. Gastroesophageal reflux and chronic respiratory disease . Am Rev Respir Dis. 1984;129:645-647. 7. Barish CF, Wu WC, Castell DO. Respiratory complications of gastroesophageal reflux . Arch Intern Med. 1985;145:1882-1888.Crossref 8. Winters C, Spurling TJ, Chobanian SJ, et al. Barrett's esophagus . Gastroenterology. 1987;92:118-124. 9. Castell DO, Wu WC, Ott DJ, eds. Gastroesophageal Reflux Disease . Mount Kisco, NY: Futura Publishing Co; 1985:5. 10. Roufail WM. Medical management of patients with reflux esophagitis . South Med J. 1978;71( (suppl 1) ):43-44.Crossref 11. Bennett JR. Medical management of gastro-esophageal reflux . Clin Gastroenterol. 1976;5:175-185. 12. Richter JE. A critical review of current medical therapy for gastroesophageal reflux disease . J Clin Gastroenterol. 1986;8( (suppl 1) ):72-80.Crossref 13. Castell DO. Medical therapy for reflux esophagitis: 1986 and beyond . Ann Intern Med. 1986;194:112-114.Crossref 14. Castell DO. Future medical therapy of reflux esophagitis . J Clin Gastroenterol. 1986;8( (suppl 1) ):81-85.Crossref 15. Johnson LF, DeMeester TR. Twenty-four hour pH monitoring of the distal esophagus . Am J Gastroenterol. 1974;62:325-332. 16. Babka JC, Hager GW, Castell DO. The effect of body position on lower esophagus sphincter pressure . Dig Dis. 1973;18:441-442. Letter.Crossref 17. DeMeester TR, Johnson LF, Joseph GJ, et al. Patterns of gastroesophageal reflux in health and disease . Ann Surg. 1976;184:459-470.Crossref 18. Kjellen G, Tibbling L. Influence of body position, dry and water swallows, smoking, and alcohol on esophageal acid clearing . Scand J Gastroenterol. 1978;13:283-288.Crossref 19. Stanciu C, Bennett JR. Effects of posture on gastro-oesophageal reflux . Digestion. 1977;15:104-109.Crossref 20. Johnson LF, DeMeester TR. Evaluation of elevation of the head of the bed, bethanechol, and antacid foam tablets on gastroesophageal reflux . Dig Dis Sci. 1981;26:673-680.Crossref 21. Hamilton JW, Boisen RJ, Yamamoto DT, et al. Sleeping on a wedge diminishes exposure of the esophagus to refluxed acid . Dig Dis Sci. 1988;33:518-522.Crossref 22. Kleinman M, Plain G. Reflux esophagitis and the waterbed . JAMA. 1987:257:2033.Crossref 23. Wang JC, Castell DO, Sinclair JW, Wu WC. Does sleeping on a waterbed promote gastroesophageal reflux? Dig Dis Sci. 1989;34:1585-1589.Crossref 24. Richter JE, Castell DO. Drugs, foods, and other substances in the cause and treatment of reflux esophagitis . Med Clin North Am. 1981;65:1223-1233. 25. Babka JC, Castell DO. On the genesis of heartburn: the effects of specific foods on the lower esophageal sphincter . Dig Dis. 1973;18:391-397.Crossref 26. Chernow B, Castell DO. Diet and heartburn . JAMA. 1979;241:2307-2308.Crossref 27. Castell DO. Diet and the lower esophageal sphincter . Am J Clin Nutr. 1975;28:1296-1298. 28. Wright LE, Castell DO. The adverse effect of chocolate on lower esophageal sphincter pressure . Dig Dis. 1975;20:703-707.Crossref 29. Murphy DW, Castell DO. Chocolate and heartburn: evidence of increased esophageal acid exposure after chocolate ingestion . Am J Gastroenterol. 1988;83:633-636. 30. Sigmund CJ, McNally EF. The action of a carminative on the lower esophageal sphincter . Gastroenterology. 1969;56:13-18. 31. Allen ML, Mellow MH, Robinson MG, Orr WC. The effect of raw onions on acid reflux and reflux symptoms . Am J Gastroenterol. 1990;85:377-380. 32. Nebel OT, Castell DO. Lower esophageal sphincter pressure changes after food digestion . Gastroenterology. 1972;63:778-783. 33. Becker DJ, Sinclair J, Castell DO, Wu WC. A comparison of high and low fat meals on postprandial esophageal acid exposure . Am J Gastroenterol. 1989;84:782-786. 34. Cohen S. Pathogenesis of coffee-induced gastrointestinal symptoms . N Engl J Med. 1980;303:122-124.Crossref 35. Thomas FB, Steinbaugh JT, Fromkes JJ, et al. Inhibitory effect of coffee on lower esophageal sphincter pressure . Gastroenterology. 1980;79:1262-1266. 36. Salmon PR, Fedail SS, Wurzner HP, et al. Effect of coffee on human lower oesophageal function . Digestion. 1981;21:69-73.Crossref 37. McArthur K, Hogan D, Isenberg JI. Relative stimulatory effects of commonly ingested beverages on gastric acid secretion in humans . Gastroenterology. 1982;83:199-203. 38. Price SF, Smithson KW, Castell DO. Food sensitivity in reflux esophagitis . Gastroenterology. 1978;75:240-243. 39. Lloyd DA, Borda IT. Food-induced heartburn: effect of osmolality . Gastroenterology. 1981;80:740-741. 40. Hogan WJ, Viegas de Andrade SR, Winship DH. Ethanol-induced acute esophageal motor dysfunction . J Appl Physiol. 1972;32:755-760. 41. Vitale G, Cheadle WG, Patel B, et al. The effect of alcohol on nocturnal gastroesophageal reflux . JAMA. 1987;258:2077-2079.Crossref 42. Dennish GW, Castell DO. Inhibitory effect of smoking on the lower esophageal sphincter . N Engl J Med. 1971;284:1136-1137.Crossref 43. Stanciu C, Bennett JR. Smoking and gastro-esophageal reflux . BMJ. 1972;3:793-795.Crossref 44. Kahrilas PJ, Gupta RR. Mechanisms of acid reflux associated with cigarette smoking . Gut. 1990;31:4-10.Crossref 45. Kahrilas PJ, Gupta RR. The effect of smoking on salivation and esophageal acid clearance . J Lab Clin Med . In press. 46. Koelz HR, Birchler R, Bretholz A, et al. Healing and relapse of reflux esophagitis during treatment with ranitidine . Gastroenterology. 1986;91:1198-1205. 47. Berenson MM, Sontag S, Robinson MG, et al. Effect of smoking in a controlled study of ranitidine treatment in gastroesophageal reflux disease . J Clin Gastroenterol. 1987;9:499-503.Crossref 48. Schindlbeck NE, Heinrich C, Dendorfer A, Pace F, Muller-Lissner SA. Influence of smoking and esophageal intubation on esophageal pH-metry . Gastroenterology. 1987;92:1994-1997. 49. Waring JP, Eastwood TF, Austin JM, Sanowski RA. The immediate effects of cessation of cigarette smoking on gastroesophageal reflux . Am J Gastroenterol. 1989;84:1076-1078. 50. Berquist WE, Rachelefsky GS, Kadden M. Effect of theophylline on gastroesophageal reflux in normal adults . J Allergy Clin Immunol. 1981;67:407-411.Crossref 51. Foster LJ, Trudeau WL, Goldman AL. Bronchodilator effects on gastric acid secretion . JAMA. 1979;241:2613-2615.Crossref 52. Ekstrom T, Tibbling L. Influence of theophylline on gastro-oesophageal reflux and asthma . Eur J Clin Pharmacol. 1988;35:353-356.Crossref 53. Haringsma J, Bartelsman JFWM, Tytgat GNJ. Chronic low-dose theophylline has no significant effect on lower esophageal sphincter pressure in healthy volunteers . Gastroenterology. 1989;96:A197. Abstract. 54. Hubert D, Gaudric M, Marsac J, Guerre J. Theophylline does not increase gastroesophageal reflux in asthmatic patients . Am Rev Respir Dis. 1986;133:A320. Abstract. 55. Sontag SJ, O'Connell S, Khandelwall S, et al. Most asthmatics have asthmatic gastroesophageal reflux with or without bronchodilator therapy . Gastroenterology. 1990;99:613-620. 56. Schindlbeck NE, Heinrich C, Huber RM, Muller-Lissner SA. Effects of albuterol on esophageal motility and gastroesophageal reflux in healthy volunteers . JAMA. 1988;260:3156-3158.Crossref 57. Castell DO. The lower esophageal sphincter: physiologic and clinical aspects . Ann Intern Med. 1975;83:390-401.Crossref 58. Richter JE, Dalton CB, Buice RG, Castell DO. Nifedipine: a potent inhibitor of contractions in the body of the esophagus . Gastroenterology. 1985;89:549-554. 59. Van Thiel DH, Gavaler JS, Stremple J. Lower esophageal sphincter pressure in women using sequential oral contraceptives . Gastroenterology. 1976;71:232-234. 60. Bainbridge ET, Nicholas SD, Newton JR, Temple JG. Gastro-oesophageal reflux in pregnancy: altered function of the barrier to reflux in asymptomatic women during early pregnancy . Scand J Gastroenterol. 1984;19:85-89. 61. Van Thiel DH, Gavaler JS, Joshi SN, Sara RK, Stremple J. Heartburn of pregnancy . Gastroenterology. 1977;72:666-668. 62. O'Brien TF. Lower esophageal sphincter pressure and esophageal function in obese humans . J Clin Gastroenterol. 1980;2:145-148.Crossref 63. Hagen J, Deitel M, Khanna K, lives R. Gastroesophageal reflux in the massively obese . Int Surg. 1987;72:1-3. 64. Mercer CD, Wren SF, DaCosta LR, Beck IT. Gastroesophageal pressure gradients and lower esophageal sphincter pressures in severely obese patients . Gastroenterology. 1982;82:1129. Abstract. 65. Dent J. Recent views on the pathogenesis of gastro-oesophageal reflux disease . Baillieres Clin Gastroenterol. 1987;1:727-745.Crossref 66. Schofield PM, Bennett DH, Whorwell PJ, et al. 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Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1991

References