Effect of Increased Intra-abdominal Pressure on the Esophagogastric Junction: A Systematic Review

Stefano Siboni, Luigi Bonavina, Benjamin D. Rogers, Ciara Egan, Edoardo Savarino, C. Prakash Gyawali, Tom R. Demeester

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

With the advent of high-resolution esophageal manometry, it is recognized that the antireflux barrier receives a contribution from both the lower esophageal sphincter (intrinsic sphincter) and the muscle of the crural diaphragm (extrinsic sphincter). Further, an increased intra-abdominal pressure is a major force responsible for an adaptive response of a competent sphincter or the disruption of the esophagogastric junction resulting in gastroesophageal reflux, especially in the presence of a hiatal hernia. This review describes how the pressure dynamics in the lower esophageal sphincter were discovered and measured over time and how this has influenced the development of antireflux surgery.

Original languageEnglish
Pages (from-to)821-830
Number of pages10
JournalJournal of Clinical Gastroenterology
Volume56
Issue number10
DOIs
StatePublished - Nov 1 2022

Keywords

  • crural diaphragm
  • esophageal acid exposure
  • esophageal manometry
  • gastroesophageal reflux disease
  • high-resolution manometry
  • intra-abdominal pressure
  • intragastric pressure
  • lower esophageal sphincter
  • straight leg raise

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