Aims of research project:
To identify key features of the gastro-esophageal junction (structure and function) that
protects the esophagus from gastro-esophageal reflux investigated by combined high resolution
manometry and magnetic resonance imaging.
1. Functional factors including GEJ function (e.g. sphincter pressure) and proximal gastric
distension determine whether or not TLESR occurs; however
2. Structural factors including separation of GEJ anatomy, intra-gastric distribution of
the meal and secretions determine whether TLESR is accompanied by no reflux event, gas
reflux (belching) or reflux of ingested food and gastric secretion ('true reflux').
3. Initial findings by descriptive studies in healthy volunteers (study #1) and patients
with mild to moderate gastro-esophageal reflux disease (study #2) will be further
interrogated by a randomized, double-blind control trial of baclofen in patients with
GORD; a medication that inhibits reflux by effects on GOJ function (study #3) .