The nadir esophageal pH of reflux observed during pH monitoring i. The postprandial period is often more acidic tha. The concomitant intragastric pH. This paradox prompte. The discovery o. The "acid pocket", an area of unbuffered gastric acid that accumulates i. The proximal stomach after meals and serves a. The reservoir for acid reflux in healthy individuals and gastroesophageal reflux disease (GERD) patients. However, there are differentiating features between these populations i. The size and position o. The acid pocket, with GERD patients predisposed to upward migration o. The proximal margin ont. The esophageal mucosa, particularly when supine. This upward migration of acid, sometimes referred to as an "acid film", likely contributes to mucosal pathology i. The region o. The squamocolumnar junction. Furthermore, movement o. The acid pocket itself to a supradiaphragmatic location with hiatus hernia increase. The propensity for acid reflux by all conventional mechanisms. Consequently. The acid pocket is an attractive target for GERD therapy. It may be targeted in a global way with proton pump inhibitors that attenuate acid pocket development, or with alginate/antacid combinations that colocalize wit. The acid pocket and displace it distally, thereby demonstratin. The potential for selective targeting o. The acid pocket in GERD.
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