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A Journal on Gastroenterology, Nutrition and Dietetics

Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index

Frequency: Quarterly

ISSN 1121-421X

Online ISSN 1827-1642


Minerva Gastroenterologica e Dietologica 2008 March;54(1):97-100


Evidence for the “paradox” association between hypertensive lower esophageal sphincter and gastroesophageal reflux disease

Kouklakis G. 1, Moschos J. 1, Paikos D. 1, Tagarakis G. 2, Rouska E. 1, Mpoumponaris A. 1, Lyrantzopoulos N. 1, Molyvas E. 1, Minopoulos G. 1

1 Medical School, Democritus University of Thrace Alexandroupolis, Greece
2 Surgery Department Theageneion Hospital, Thessaloniki, Greece

There are several studies suggesting the paradoxical simultaneous presence of hypertensive lower oesophageal sphincter and gastroesophageal reflux disease. We present a case of a 22-year-old male patient who was examined in our outpatient clinic with oesophageal food bolus impaction during a meal, severe chest pain and drooling. Manometry revealed a hypertensive lower esophageal sphincter pressure (resting pressure 35 mmHg) and pHmetry revealed a DeMeester score >14.72 (43.27). Six months after therapy with lansoprazole, manometry revealed a normal lower oesophageal sphincter (resting pressure 14 mmHg) and the DeMeester score was <14.72 (5.89). The patient is now asymptomatic. This report is the only published case which exhibits the normalization of lower oesophageal pressure 6 months after gastroesophageal reflux disease management with lansoprazole, thus proving and establishing the above “paradox”.

language: English


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