Biomedical subjects
Publications and source records attributed to J R Bennett.
A radiographic method of measuring the diameter of oesophageal strictures is described. Both a liquid bolus and a solid sphere were used. The measurements obtained were compared with measurements obtained at endoscopy. It is suggested that the most effective method is to determine the maximum size of barium sphere which will pass through a stricture.
15-hour intra-oesophageal pH monitoring and symptom scores were used to compare the effect of cimetidine, 1 or 2 g daily with placebo on patients with acid gastro-oesophageal reflux. Night pain and antacid consumption were reduced by cimetidine, but other symptoms did not show significant differences. Symptomatic improvement appeared greater in smokers than non-smokers. 15-hour intra-oesophageal pH measurements showed that the number of reflux episodes was reduced in the cimetidine-treated groups.
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A postal survey of British endoscopists was carried out to discover current practice in the intubation of gastro-oesophageal malignancies. Forty-six replies were analysed, comprising about 820 intubations. There were 75 perforations (approximately 9%) and the rate was about the same for operators with experience of 20 or more intubations. Tube blockage and dislocation were the main other problems.
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A series of tests, including gastro-oesophageal sphincter pressure measurement, short-term pH tests, and 15-hour overnight oesophageal pH recording were applied to 42 normal subjects and 214 patients with typical reflux symptoms. The results were compared by multivariate discriminant analysis. Sphincter pressure measurements misclassified 32%, stressed provocative manoeuvres 14-5%, and the best single discriminator from the overnight pH study was time below pH 5, which misclassified 13%. However, a combination of the number of reflux episodes in 15 hours with their mean duration reduced misclassification to 8-8%. Using this function, a boundary between normal and reflux can be drawn, and the degree of abnormality can be expressed visually as well as numerically.
Continuous oesophageal pH measurements have been used to assess the influence of posture (lying, sitting, bed-up) on gastro-oesophageal reflux. The percentage of time during which oesophageal pH was below 5 and the number of reflux episodes was significantly reduced when patients were in bed-up position than when sitting or lying. There was no significant difference when sitting and lying positions were compared. The results suggest that by adopting the bed-up position (elevation of the head end of the bed with blocks of 28 cm), the patient will have a symptomatic benefit, the frequency of reflux is decreased, and acid clearing is improved.
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