Induced Opening of the Gastroesophageal Junction Occurs at a Lower Gastric Pressure in Gerd Patients and in Hiatal Hernia Subjects than in Normal Control Subjects

Figure 4

This is pattern II opening. This picture shows a retroflexed view of the gastroesophageal junction in a normal volunteer. The white catheter is the manometry catheter and the black tube is the endoscope. Note that the hiatus is open around the endoscope during air insufflation into the stomach but that the distal esophagus remains closed and tight around the endoscope. This subject did not have a hiatal hernia, and the esophagus was tight around the endoscope prior to air insufflation.