Volume 115, Issue 3, Pages 597-604 (September 1998) Endogenous cholecystokinin enhances postprandial gastroesophageal reflux in humans through extrasphincteric receptors  Pere Clavé, Asensio González, Araceli Moreno, Regina López, Antonio Farré, Xavier Cussó, Massimo D'amato, Fernando Azpiroz, Fèlix Lluís  Gastroenterology  Volume 115, Issue 3, Pages 597-604 (September 1998) DOI: 10.1016/S0016-5085(98)70139-8 Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Effect of endogenous CCK on gastroesophageal reflux and TLESR rate. (A) In group I studies, addition of cholestyramine (■) to the meal enhanced the rate of reflux episodes and TLESRs (□, control experiment). (B) In group II studies, CCK-A receptor blockade using loxiglumide (▨) inhibited postprandial reflux episodes and TLESRs induced by cholestyramine (■; *P < 0.05). Gastroenterology 1998 115, 597-604DOI: (10.1016/S0016-5085(98)70139-8) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 2 Examples of esophageal motility patterns associated with reflux episodes. Time marker depicts seconds. Vertical lines indicate the onset of reflux. Reflux episodes were associated with (A) TLESRs, (B) swallow-induced LES relaxations, or (C) slow downward LES pressure drifts. EB 3, esophageal body 3 cm above the LES; EB 0, esophageal body, upper end of the sleeve. Gastroenterology 1998 115, 597-604DOI: (10.1016/S0016-5085(98)70139-8) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 3 LES pressure profiles. (A) In group I studies, LES pressure decreased after the meal in both control (○) and cholestyramine (●) experiments. (B) In group II studies, loxiglumide (▵) prevented the postprandial decrease in LES pressure induced by cholestyramine (●). *P < 0.05 vs. fasting values; #P < 0.05 vs. cholestyramine. Gastroenterology 1998 115, 597-604DOI: (10.1016/S0016-5085(98)70139-8) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 4 CCK bioassay. (A) Gallbladder emptying induced by the test meal was faster with cholestyramine (●) than without (○) in group I studies. (B) In group II studies, IV loxigumide (▵) completely inhibited the postprandial gallbladder contraction induced by cholestyramine (●). Gastroenterology 1998 115, 597-604DOI: (10.1016/S0016-5085(98)70139-8) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 5 Effect of CCK-8 on basal tension of human LES strips in vitro. Data are grand means ± SEM (11 strips; 6 donors). CCK-8 induced a dose-related contraction. Gastroenterology 1998 115, 597-604DOI: (10.1016/S0016-5085(98)70139-8) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 6 Example of the effect of CCK-8 (3 × 10−9 mol/L; arrow) on basal tension and responses to EFS (0.3 Hz) of human LES strips in vitro. CCK-8 increased basal tone but did not affect the relaxation induced by EFS. Gastroenterology 1998 115, 597-604DOI: (10.1016/S0016-5085(98)70139-8) Copyright © 1998 American Gastroenterological Association Terms and Conditions