Introduction. Рostprandial acid pocket formed within 15 min after a meal and persists highly acidic for about 2 hrs as compared with the rest of the stomach contents. This postprandial phenomenon arises from the fact that the proximal portion of the cardia of the stomach does not feel the buffer effect of food.
Оbjective. Examining the role of postprandial acid pocket in the development of gastroesophageal reflux in patients with complicated forms of peptic ulcer.
Results and discussion. Diagnosis of reflux and condition of the acid pocket were studied in 102 patients with complicated forms of peptic ulcer disease with a daily esophago-pH-impedance monitoring.
In 38 patients without reflux and 22 patients with functional reflux, acid pocket located below the diaphragm during the pH-monitoring of acid porket after 15–20 min after the meal a decrease pH to 1.6–2.5 with a brief appearance of acidic liquid and mixed gastroesophageal reflux for postprandial period was found.
When hiatal hernia II–III degree, the acid pocket is located above the diaphragm. Within 1.5–2 hrs after the meal the acid pocket remained high acidity in the range 1.6–2.2. Throughout the postprandial period recorded prolonged liquid acidic gastroesophageal reflux (80.12±1.96 min) in violation of the chemical and volume esophageal clearance. Most of the reflux spread to the upper electrode impedance.
Conclusions. Duration of postprandial acid reflux and their number depends on the size and position of pockets of acid corresponding to the diaphragm. The risk of gastroesophageal reflux is higher in patients with hiatal hernia, in which the acid pocket is bigger and located with or above the diaphragm in the hernial cavity. When performing antireflux surgery for the correction of gastroesophageal reflux, it is necessary to take into account topographic features of the acid pocket.