Structure and Function of the Gastro-esophageal Junction

June 1, 2011 updated by: University of Zurich

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:

  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) .

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

24

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Switzerland
      • Zurich, Switzerland, CH-8091
        • Division of Gastroenterology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 50 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

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

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Baclofen
Baclofen suspension 40mg (single dose 90 minutes prior to physiologic measurement)
Drug: Baclofen
Baclofen suspension 40mg (single dose 90 minutes prior to physiologic measurement)
Placebo Comparator: Placebo
Placebo suspension (single dose 90 minutes prior to physiologic measurement)
Drug: Placebo
Placebo single 'dose' 90 minutes prior to study

What is the study measuring?

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

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

This is where you will find people and organizations involved with this study.

Sponsor

University of Zurich

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

February 1, 2007

Primary Completion (Actual)

May 1, 2011

Study Completion (Actual)

May 1, 2011

Study Registration Dates

First Submitted

July 21, 2009

First Submitted That Met QC Criteria

January 20, 2010

First Posted (Estimate)

January 21, 2010

Study Record Updates

Last Update Posted (Estimate)

June 2, 2011

Last Update Submitted That Met QC Criteria

June 1, 2011

Last Verified

May 1, 2011

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • EK 1361

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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