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Biomedical subjects

J R Bennett

Publications and source records attributed to J R Bennett.

At least 91 records · Page 5Linked to original sources

Preliminary communications.

The effects of pentazocine on colonic motor activity were studied in five normal subjects, five patients with irritable bowel syndrome, and five patients with diverticular disease. The drug decreased intraluminal colonic pressures in all patients but one. Since morphine, which increases intraluminal colonic pressures, is contraindicated in patients with abdominal pain of colonic origin (diverticular disease, irritable bowel syndrome), we suggest that pentazocine may be a useful drug in such cases.

Adult↗

Oesophageal acid clearing: one factor in the production of reflux oesophagitis.

Oesophageal acid clearing has been measured by counting the number of swallows needed to raise the lower oesophageal pH from 1.5 to 5.0 after instilling 15 ml 0.1 N hydrochloric acid. Normal subjects all had a result less than 12, as did asymptomatic patients with hiatal hernias. Patients with symptomatic gastrooesophageal reflux tended to have abnormal acid clearance, as did those with oesophageal motility disorders. Acid clearance correlated well with the mean duration of spontaneous episodes of acid reflux during 15-hour continuous recordings of lower oesophageal pH. Abnormal acid clearance was improved by raising the bedhead, by medical treatment for oesophagitis, and by metoclopramide. We conclude that abnormal acid clearing may result from disturbed oesophageal motility and render patients with these disorders susceptible to reflux oesophagitis. However, it also seems that gastrooesophageal reflux may lead to impaired acid clearance, both by creating abnormal motility and by effects on the oesophageal wall, and thus lead to a ;vicious-spiral' oesophagitis. In treating gastrooesophageal reflux, attention must be paid to improving acid clearance.

Adolescent↗

Metoclopramide in gastrooesophageal reflux.

In 30 patients with gastrooesophageal reflux, intravenous metoclopramide (Maxolon) has been shown to increase the gastrooesophageal sphincter pressure. The rise is dose-related until a maximum pressure, proportional to the resting sphincter tone, is reached. The effect is reversed by atropine. Peristaltic waves are increased in pressure by metoclopramide.In 18 patients with gastrooesophageal reflux intravenous metoclopramide diminished the frequency of reflux episodes and increased the rate at which the oesophagus emptied itself of an acid load.

Adolescent↗

Smoking and gastro-oesophageal reflux.

Gastro-oesophageal sphincter pressure and intraoesophageal pH has been studied in 25 chronic smokers who complained of heartburn. Smoking a cigarette invariably caused a fall in sphincter pressure, and pH measurements showed an increased tendency for reflux to occur while smoking. When lower oesophageal pH was measured overnight one-third of all reflux episodes occurred while the patients were smoking, and reflux was seen during the smoking of two-thirds of all the cigarettes consumed. It is concluded that cigarette smoking is a common reversible cause of gastro-oesophageal reflux.

Adult↗