Structure and Function of the Gastro-esophageal Junction
Combined Magnetic Resonance Imaging and High Resolution Manometry Studies
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.
Hypothesis:
- Functional factors including GEJ function (e.g. sphincter pressure) and proximal gastric distension determine whether or not TLESR occurs; however
- 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').
- 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) .
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Zurich, Switzerland, CH-8091
- Division of Gastroenterology
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion criteria:
Study #1:
- healthy male and female volunteers
- aged at least 18 and not more than 49 y
- no history of gastrointestinal symptoms
- able to communicate well with the investigators and to comply with the requirements for the entire study
- who provided written informed consent before participating in the study, after being given a full description of the trail.
Study #2 and #3:
- male and female patients with mild to moderate gastro-oesophageal reflux disease defined by presence of (1) reflux symptoms (2) pathological esophageal acid exposure between 5-10% on 24 hour ambulatory testing
- aged at least 18 and not more than 49 y
- no history of gastrointestinal symptoms
- able to communicate well with the investigators and to comply with the requirements for the entire study
- who provided written informed consent before participating in the study, after being given a full description of the trail.
Exclusion criteria:
- with present psychiatric disorders or mental impairment limiting the ability to comply with study requirements
- with use of medications influencing upper GI motility within one week of the study (i.e. beta- blocker, calcium channel blockers, nitrates, prokinetic drugs, macrolide antibiotics)
- with regular intake of medication; occasional use of analgesic e.g. aspirin, paracetamol is allowed
- with symptoms or a history of gastrointestinal disease other than gastro-esophageal reflux disease (in study #2 and #3)
- suffering from known liver, kidney, cardiovascular, neurological or pulmonary disease
- with any evidence of infectious disease
- with evidence or history of drug or alcohol abuse
- with insufficient knowledge of the German language • who, for any reason, are unable to complete the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Baclofen
Baclofen suspension 40mg (single dose 90 minutes prior to physiologic measurement)
|
Baclofen suspension 40mg (single dose 90 minutes prior to physiologic measurement)
|
|
Placebo Comparator: Placebo
Placebo suspension (single dose 90 minutes prior to physiologic measurement)
|
Placebo single 'dose' 90 minutes prior to study
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Gastro-oesophageal insertion angle, contact span (of stomach on oesophagus)
Time Frame: Pre- and post-meal ingestion
|
Gastro-oesophageal morphology from MRI imaging: insertion angle, contact span (of stomach on oesophagus) assessed from 3D models of stomach reconstructed from MRI imaging
|
Pre- and post-meal ingestion
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
gastric emptying
Time Frame: post-meal
|
dynamic change in gastric and meal volumes over course of study assessed from MRI imaging.
gastric emptying assessed from complete data set
|
post-meal
|
|
gastric accommodation
Time Frame: post-meal
|
dynamic change in gastric and meal volumes over course of study assessed from MRI imaging.
gastric accommodation assessed from complete data set
|
post-meal
|
|
number of reflux events
Time Frame: post-meal
|
assessed by presence of common cavity events on (high resolution) manometry
|
post-meal
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Gastrointestinal Diseases
- Esophageal Motility Disorders
- Deglutition Disorders
- Esophageal Diseases
- Gastroesophageal Reflux
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- GABA Agents
- Neuromuscular Agents
- Muscle Relaxants, Central
- GABA Agonists
- GABA-B Receptor Agonists
- Baclofen
Other Study ID Numbers
Other Study ID Numbers
- EK 1361
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