If the stomach is contracting and empty this will decrease the incidence of reflux. 6. Antacids such as Mylanta and Maalox are effective and very safe as they are not absorbed into the bloodstream. 7. H2 blockers Zantac, Pepcid and Tagamet are effective. While they are absorbed into the bloodstream, studies have not revealed any adverse effects on the developing fetus. 8. Proton pump inhibitors Nexium , Aciphex and Prevacid should be used only in severe cases that are not responsive to H2 blockers. While they are felt to be safe, there are no long-term studies available confirming this. In most cases, acid reflux is easily treated, even in pregnancy. If there are however, more refractory symptoms that result in complications such as gastrointestinal bleeding, difficulty swallowing or weight loss, your obstetrician may refer you to a gastroenterologist. Other conditions such as gallbladder disease, pancreatitis or even cancers of the esophagus and stomach can mimic gastroesophageal reflux disease. Please provide your email address and password to access your account.
His poems, essays and photographs have appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden’s Ferry Review, Huffington Post, the Mississippi Review, and Slate among others. He is a member of both the National Writers Union, the International Federation of Journalists, and covers San Francisco Health News for Examiner.com . Ads by Google: Celiac.com 11/21/2008 – Not much is known about what effects, if any, a gluten-free diet might have upon gastroesophageal reflux disease-related symptoms (GERD-rs) in people with celiac disease. A team of researchers recently set out to assess the recurrence of GERD-rs, in celiac patients with nonerosive reflux disease (NERD). Out of a total of 105 adult patients with celiac disease, the team found 29 with celiac disease who presented with the NERD. Those 29 were enrolled in the study, and compared against a control group of thirty non-celiac patients with NERD. After 8 weeks of PPI treatment the team found that 25 (86.2%) celiac patients saw GERD-rs resolve, compared to just 20 (66.7%) control subjects. The team used clinical means to assess recurrence of GERD-rs at 6, 12, 18, and 24-month intervals after initial proton-pump inhibitor (PPI) treatment were withdrawn for 8 weeks. In the celiac disease group, just five patients (20%) had a recurrence of GERD-rs at 6 months, but none had recurrence at 12, 18, and 24 months, while the control group showed recurrence in six of 20 controls (30%) at 6 months, in another six (12/20, 60%) at 12 months, in another three (15/20, 75%) at 18 months, and in another two (17/20, 85%) at 24 months. This is the first study to evaluate the effect of a gluten free diet in the nonerosive form of GERD in patients with celiac disease, via a clinical long-term follow-up, and the results suggest that a gluten free diet could be helpful reducing GERD symptoms and in preventing of their recurrence. J Gastroenterol Hepatol. 2008;23(9):1368-1372. As always, Celiac.com welcomes your comments (see below). Get FREE Celiac.com email alerts (1-3 email per month with the latest celiac disease research and information, gluten-free recipes, etc.). Article Options
But for those who prefer a more natural approach, there are other solutions. Natural remedies for heartburn include: *Chewing gum Chew a piece of sugar-free gum 30 minutes after eating, which can help wash away acid. *Licorice Experts say licorice has stomach-healing properties that can get to the root of the problem rather than just calming symptoms. But be careful eating too much could have serious side effects. *Baking soda Mixing a half teaspoon into a glass of water can help neutralize stomach acid. But it shouldnt be used for chronic heartburn because its high in salt. *Slippery elm Research suggests that adding a couple of tablespoons of this herb to a glass of water can help coat and protect the stomach. *Aloe This plant can reduce inflammation in the stomach. Some experts suggest drinking aloe juice, but use caution, because it can also be a laxative. *Melatonin Taking this supplement can help protect the digestive tract. Many home remedies are not approved by the U.S.
Start by removing one of the foods from the diet for at least a week to see if there is any improvement. If there is none, eliminate another food the next week. Also eat smaller, more frequent meals to cut down on the over production of stomach acid. Apple Cider Vinegar Another thing that can be tried to manage acid reflux is the apple cider vinegar remedy. It is thought that apple cider vinegar neutralizes other stronger acids that are in the stomach. Take three teaspoons of apple cider vinegar, mix it into at least an eight ounce glass of water, and add honey to taste. Drink it before meals to prevent acid reflux naturally or whenever heartburn is experienced. Herbs In his book, The Green Pharmacy, Dr. James A. Duke recommends the herbs licorice and chamomile as natural remedies for acid reflux. Licorice can reduce the production of stomach acid, and it can easily be taken in a tea form. Drink one cup when experiencing heartburn, but be sure not to use it consistently over a long period of time since it can cause potassium deficiency and high blood pressure.
It looks like stringy globs of stuff floating around. This sounds disgusting, but the mother contains enzymes that can help with healing. Bragg’s Apple Cider Vinegar, available at natural food stores, is usually recommended. Shake up the apple cider vinegar to distribute the mother throughout the vinegar, and take one tablespoon before every meal. It can work in as little as three days, but usually it takes three to nine months to completely get rid of heartburn symptoms. Aloe Vera Aloe vera juice has been used in Europe for many years as a natural remedy for acid reflux. A quarter cup taken about 20 minutes before eating will help to soothe an irritated, inflamed esophagus. Don’t try to squeeze the gel out of the leaves if you have an aloe vera plant, as it contains aloe latex, which is a powerful laxative. Buy only aloe vera juice or gel that specifically says it’s for internal use. It can be found at natural food stores. Licorice Deglycyrrhizinated licorice, or DGL, helps to stop heartburn by stimulating the production of the protective mucus that lines the digestive tract. This helps to protect the esophagus from stomach acid. It also boosts the immune system and is a very strong anti-inflammatory. Take two 250-milligram capsules before each meal. Instead of taking DGL with water, it’s best to suck on the capsules and let them slowly dissolve in the mouth.
Like licorice root, slippery elm coats the lining of the digestive tract, protecting delicate tissues. Additionally, it relieves coughing and throat pain from regurgitated stomach acids. Use bromelain, an enzyme that aids the breakdown of proteins and provides digestive support. Bromelain encourages faster digestion and increases motility, which prevents foods from remaining in the stomach to putrefy and cause acid reflux. Lifestyle Changes Fortunately, for those suffering from acid reflux and related conditions, there are a variety of lifestyle changes that may also relieve symptoms. Avoid over-the-counter antacids, which create a feedback loop in the digestive tract that produces greater amounts of stomach acid and of a chance for putrefaction and resulting pain. Eat smaller, more frequent meals and chew food thoroughly. Saliva mixes with food, predigests it, and signals the stomach to prepare for additional digestive functions. Loosen clothing around the waist after eating and avoid bending over or lifting heavy objects within an hour of eating. Raise the head and upper body into an elevated position during sleep to provide relief for breathing problems. Raising the upper body may prevent regurgitation of stomach contents and relieve coughing and choking. Use either an acid reflux pillow wedge or raise the head of the bed by 4 to 6 inches. By making a few simple dietary and lifestyle changes, most people can reduce the incidence of digestive problems and feel better.
What Are the Symptoms of Acid Reflux Disease? People with acid reflux disease often have some or all of the following symptoms: Pain when swallowing Bad breath and/or bad taste in the mouth Burping How Is Acid Reflux Diagnosed? If you experience classic symptoms of acid reflux disease — chronic heartburn and regurgitation — without any troublesome complications, it may be relatively easy for your doctor to make an acid reflux diagnosis. A few people have GERD that doesn’t respond to treatment. Or they may have other concerning symptoms, such as weight loss , difficulty swallowing, anemia , or black stools. If you’re one of them, you may need any of the following tests. Diagnosing Acid Reflux With a Barium Swallow Radiograph Your doctor may decide to use a special X-ray procedure — the barium swallow radiograph — to rule out any structural problems in your esophagus. In this painless acid reflux test, you will be asked to swallow a solution of barium. The barium enables doctors to take X-rays of your esophagus. Barium swallow isn’t a surefire method of diagnosing GERD . Only one out of every three people with GERD has esophageal changes that are visible on X-rays.
Dr. Koufman diagnosed me not only with Gastroesophageal reflux disease (GERD), but also with Laryngopharyngeal reflux (LPR). In other words, stomach acid was not only coming back into my esophagus, but was also reaching my voice box and throat. This not only causes the discomfort of heartburn, but also puts patients at risk for conditions like Barretts disease and possibly even throat cancer. Many of the patients Dr. Koufman sees in her New York City office suffer from LPR but not the classic reflux symptom of heartburn . This condition, for which she coined the term Silent Reflux, is often misdiagnosed as allergies or asthma. The first red flag is that patients come with symptoms that arent getting addressed by their doctors, says Dr. Koufman. The lung doctors really dont recognize that reflux is in the throat all the time, and if its getting in the throat its getting in the lungs. She explained to me that diet alone could treat about 30 percent of her patients, but that my condition was serious enough to warrant medication as well. Dr. Koufman explained that the tissues in the throat are much more sensitive than those in the esophagus below, which means that Silent Reflux needs more aggressive treatment. Normally diet plays a bigger role, she says, in addition to giving me a combination of two medications to prevent reflux.
Roach I was on Pradaxa because I have atrial fibrillation. I had a total knee replacement in November 2012, and within a month I had to have hematomas removed on two separate occasions. My surgeon said that the blood thinner, Pradaxa, might have been the culprit. What are your thoughts? I am going to start taking Xarelto. Could this cause the same problem in the future? Answer Both medications reduce the bodys ability to make blood clots. The major side effect of both is excessive bleeding. Any surgery increases the likelihood of bleeding, so the combination of a major surgery, like a total knee replacement, with a medication that increases bleeding risk means that bleeding is going to be likely. However, as the body heals in the days and even months after surgery, the risk of bleeding goes down. If you were to require another surgery, the risk of bleeding would be high. On the other hand, the risk of a blood clot causing stroke in people with atrial fibrillation is about 5 percent per year without treatment, which is why treatment is recommended. It sometimes can be hard to balance clot/stroke risk against bleeding risk. Dr. Keith Roach is a physician at Weill Cornell Medical College and New York Presbyterian Hospital.Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O.
Health: New Acid Reflux Treatment Available In Philadelphia
For Hannah Grubow it happened right after she ate. Just coughing and gagging constantly, said Hannah. Thirty million Americans have acid reflux. It happens when acid from the stomach backs up into the esophagus. Traditionally its treated with medications like Prilosec and Nexium. Nothing really worked, said Hannah. When diet changes and medications dont work, surgery was the only alternative until now. Its a fantastic procedure, a great technology, a big advance in what weve had in the past, said Dr. Ramsey Dallal, with Einstein Healthcare Network. Its the first in Philadelphia to offer a new treatment for acid reflux called the LINX. Its a tiny magnetic ring on a flexible band. It pops open so you put it inside the abdomen like this. Its such a simple idea of magnets on a string, said Dr. Dallal. The LINX, when in place around the esophagus, opens to allow food into the stomach and closes to prevent reflux. People are like wow thats so simple, and it makes sense, said Dr. Dallal. He says the LINX is surgically placed laparoscopically with general anesthesia. There are some risks, like infection, but Jeff says the outpatient procedure was a breeze. It has cured me. I mean its unbelievable. Its something that seems so simple, but it really. It works amazingly, said Jeff. Ninety-three percent of patients who get the LINX no longer had to take any heartburn medicine, according to one study. Hannah says she got her life back.
Diagnosis and Treatment of Acid Reflux in Infants and Children
Mayo Clinic experts advise holding a full bottle upside down; only a few drops of milk or formula should drop from the nipple at one time. You can also thicken your baby’s milk or formula using a little bit of rice cereal, if your child’s pediatrician is on board; however, you may need to enlarge the hole in the bottle’s nipple to allow the milk or formula to flow through. Feedings Try smaller feedings at increased intervals to reduce acid reflux. The Mayo Clinic advises feeding your infant around 1 oz. or even less or restricting breast-feeding to only one breast. Make sure to burp your baby right after she’s been fed. The Mayo Clinic cautions you against putting your baby over your shoulder, as this puts additional pressure on your baby’s tummy; rather, position her upright while holding her head with your hand. Positioning Post-feeding positioning can also decrease instances of acid reflux in your baby. The Mayo Clinic recommends sitting your child upright using a front pack, backpack or baby seat for 15 to 30 minutes after each meal (the American Academy of Pediatrics advocates upright positioning for a full 30 minutes). This permits gravity to work in your baby’s favor by keeping gastric acid in his tummy, not his esophagus. Make sure not to jostle your infant while his meal is still digesting.
Laura Wilson Acid reflux can be an annoyance for adults who have to deal with it, but sometimes it even affects infants and children. Parents can be aware of diagnosis and treatment of reflux in their children so they know what to expect if their child shows symptoms of Gastroesophageal Reflux (GER). What is Gastroesophageal Reflux? Gastroesophageal reflux is caused when the contents of the stomach back up into the esophagus. The esophageal sphincter is the muscle that allows the contents pass through the esophagus into the stomach, and when that opens and allows food back out the opposite way it can cause discomfort from gastroesophageal reflux, commonly referred to as acid reflux. GER is actually fairly common in infants, usually because the esophageal sphincter has not fully developed, and the opening between the stomach and esophagus is not entirely closed, at least not all the time. In infants, the tell-tale sign of reflux is problems with spitting up. All babies spit up a little, but babies with reflux have extreme episodes where there are large amounts of regurgitation. Many infants with GER struggle with weight gain as a result. Symptoms of GER in Children While most infants outgrow reflux sometime around their first birthday, for some children it remains an ongoing problem. According to the National Digestive Diseases Information Clearinghouse in the article Gastroesophageal Reflux in Children and Adolescents symptoms of GER may include: Heartburn Vomiting Diagnosis of Acid Reflux Parents who are concerned about acid reflux in their children should speak to a doctor. There are several diagnostic methods used to confirm whether a child has GER. Barium Test: This is an x-ray taken of the upper digestive tract after a person swallows a white substance called barium which will show up on an x-ray. The test will show whether the barium is being allowed back into the esophagus from the stomach. Endoscopy: A child is sedated during this test so that a small wire with a camera can be inserted down the esophagus into the stomach. A doctor will be able to look at the area and take tissue samples to determine if the area has been damaged from acid reflux.
It can also cause babies to aspirate on their food or drink. There are several types of treatments and remedies for treating acid reflux, ranging from medicinal to homeopathic. Medications for the Treatment of Acid Reflux in Babies For severe acid reflux symptoms, the child’s pediatrician may prescribe medicine such as Axid or Zantac. The child’s doctor should be informed of any changes that occur while on any medication. Pacifiers Have Been Proven to Help Treat Symptoms of Acid Reflux Pacifiers have been shown to increase saliva, which can neutralize some of the acid coming up, and help reduce acid reflux. Sucking on a pacifier at bedtime also decreases the occurrence of sudden infant death syndrome. Pacifiers should be checked often to make sure they are not old or gummy. Parents also need to make sure they purchase the correct size pacifier for the baby’s age to prevent choking. The age range can usually be found on the outside of the packaging. Avoid Overfeeding a Baby With Acid Reflux Babies with acid reflux should eat several small meals throughout the day to avoid overeating and should be burped often. If the mother is unable to breastfeed, there are many healthy alternatives, including formulas with added rice starch. However, rice should not be added to formula without talking to a pediatrician first. The child’s pediatrician may prescribe a special formula, such as Alimentum to help reduce spit-up.
and European medical centers to test the device prior to its March 2012 approval by the U.S. Food and Drug Administration. “These results show that there is another option for the millions of people suffering from chronic reflux,” Lipham said. “Currently, the Keck Medical Center of USC is one of only 30 sites in the country certified to implant the device.” The LINX Reflux Management System, manufactured by Minnesota-based Torax Medical, Inc., is like a bracelet made up of magnetic, titanium beads implanted around the end of the esophagus, where the lower esophageal sphincter is located. The lower esophageal sphincter is the valve that prevents reflux, and GERD develops when this valve is weakened. Implantation of the device is potentially an outpatient procedure that can be completed in 15 to 20 minutes, Lipham said. Lipham and his colleagues assessed 100 patients with GERD before and after surgery, finding that acid reflux decreased, reflux symptoms improved and the use of medication to manage those symptoms decreased for most patients. Severe regurgitation was eliminated in all patients. More than 9 in 10 patients reported satisfaction with their overall condition after having the procedure, compared to 13 percent before treatment while taking medication. Follow-up studies are still required to assess long-term safety. Lipham says the LINX device is best for patients with mild to moderate reflux that cannot be adequately controlled by medication or for patients who do not want to take medication to manage the disease. More than 60 million Americans experience heartburn at least once a month and some studies have suggested that more than 15 million experience heartburn symptoms every day, according to the American College of Gastroenterology. Surgical treatment of reflux disease had been limited to a procedure called a Nissen fundoplication, which involves recreating the esophageal sphincter. While fundoplication is recommended for those with severe reflux, it is a complicated procedure that prevents the ability to belch or vomit and often leads to bloating or gas problems.
When a baby spits up, it may not be acid reflux disease
Uncomplicated gastrointestinal reflux (GER), marked by the constant regurgitation or spitting up of stomach contents and sometimes accompanied by other symptoms including coughing, hiccups, vomiting, and irritability occurs in more than 60% of otherwise healthy infants and is the topic of discussion with pediatricians at 25% of all routine six-month doctor visits, says the report in the May issue of Pediatrics, published online today. “Having an infant who regurgitates regularly, regardless of whether they might have some worrisome symptoms such as coughing, choking or irritability to go along with it, can pose concern and a lot of hurdles for families until the child grows out of the problem,” says pediatric gastroenterologist David Gremse, a professor at the University of South Alabama Medical School and co-author of the study. But research shows that most infants outgrow symptoms by about 1 year, says Gremse. According to one survey, the condition “tends to peak at 3 to 4 months of age and then starts to decline after that,” he says. A more problematic condition, gastroesophageal reflux disease (GERD) affects a much smaller percentage of infants; symptoms include regurgitation, vomiting and irritability, but also refusal to eat, poor weight gain, indications of stomach ache and sleep disturbances. “These children oftentimes do benefit from acid suppression medication to control symptoms and heal any acid damage to the esophagus that may be present,” says Gremse. He notes, however, that other conditions, such as colic and irritability from milk protein intolerance also can produce some of these symptoms. There’s no indication that infant reflux is becoming more common, although for school-age children “obesity makes reflux a lot worse because it increases pressure on your belly,” says Carlo Di Lorenzo, a pediatric gastroenterologist at Nationwide Children’s Hospital in Columbus, Ohio. He was not involved in study. Children born with birth defects affecting the esophagus are at a much higher risk of having GERD, as are children with some chronic respiratory conditions such as cystic fibrosis, and babies born with neurologic impairments, the report says. It also addresses “some of the potential over-prescribing of the strongest acid blockers, such as protein pump inhibitors,” in the treatment of infants and young children,” says Gremse. The report encourages pediatricians to follow guidelines developed by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition when diagnosing and treating reflux conditions. It recommends lifestyle changes, which can include feeding and/or position changes as first-line therapy for both conditions, while medications are explicitly indicated only for patients diagnosed with GERD. Giving infants smaller but more frequent feedings and making sure nursing mothers limit spicy and fatty foods and caffeine “can often make a big difference,” Gremse says.
Reflux esophagitis represents all esophageal lesions caused by gastroesophageal reflux disease, not seen in all cases of gastroesophageal reflux disease. Gastroesophageal reflux disease is a clinical entity relatively common in medical practice and is often has a polymorphic symptomatic picture. GERD Prevalence Gastroesophageal reflux disease has a prevalence of 4% in the general population, increasing with age. The current trend is the increase in the incidence of the disease. Etiopathogenesis In the case of gastroesophageal reflux disease, are describe two mechanisms that determine the inefficient antireflux mechanism: Physiological causes: decreased lower esophageal sphincter pressure. Under normal conditions, lower esophageal sphincter pressure is 20 to 25 mm Hg and disappears only when swallowing. Gastroesophageal reflux occurs when the lower esophageal sphincter relaxes outside swallowing, or when lower esophageal sphincter pressure falls below 6 mm Hg, thus allowing the passage of stomach contents into the esophagus. Lower esophageal sphincter pressure may be reduced by factors like drugs (anticholinergics, benzodiazepines, calcium channel blockers), food (chocolate, onions, fats, citrus), coffee, smoking and alcohol; decreased gastric motility with delayed gastric emptying; damage to esophageal clearance by acid stomach contents which flows backward into the esophagus. This esophageal clearance with the swallowed saliva serve as a tampon mechanism for the acid content of the stomach which flows backward into the esophagus; Mechanical causes: hiatal hernia causes a decrease of the tonus of the lower esophageal sphincter, which favors the reflux; increased intra-abdominal pressure leads to widening of the diaphragmatic hiatus, explaining the occurrence of gastroesophageal reflux disease in pregnant women, obese, etc.; His angle widening, the angle between the esophagus and stomach is usually very sharp, with the role of a valve at the entrance of the stomach. In obese it widens and loses physiological role. Development and severity of gastroesophageal reflux disease is caused by the presence of three conditions: increased frequency of reflux; aggressive effect of stomach contents on the esophageal mucosa.
Smoking may increase your risk for heartburn and acid reflux disease in many ways. For example, it may increase the amount of acid secreted by your stomach and interfere with the function of muscles that help keep acid down. Reduce reflux while sleeping. These steps will help reduce reflux when you sleep: Put blocks under the head of your bed to raise it at least 4 to 6 inches. This helps keep your stomach’s contents down. However, it doesn’t work to simply use lots of extra pillows because this position may increase pressure on your abdomen. Stop eating at least two or three hours before lying down. Try sleeping in a chair for daytime naps. Lessen the pressure. Often, extra pressure around your abdomen increases acid reflux. Try these steps: Don’t wear tight clothes or tight belts. If you’re overweight or obese, take steps to lose weight with exercise and diet changes. Can Medication Help Heartburn? Over-the-counter medicine can help neutralize stomach acid. Antacids give quick, short-term relief for many people. Don’t overdo it, though, or you may trigger other side effects, such as diarrhea or constipation.
But research has shown otherwise. Now it is more relevant to adopt an Acid Reflux Diet that can be used in conjunction with other medication that treats acid reflux disease or the diet can be followed alone. One of the main components of the Acid Reflux Diet is the management of your eating conditions. The Acid Reflux Diet can be followed quite simply and it does not involve purchasing special foods or supplements. Individuals with Acid Reflux disease might find that particular foods invoke an episode. Therefore, it is best to monitor your diet by excluding these foods that you feel aggravate your condition. PRO The Acid Reflux Diet is easy to follow It can help manage the symptoms of acid reflux disease It does not involve purchasing any special diet food or kitchen equipment Its avoidance of high fat foods and sugary sodas and its reliance on eating small meals spaced evenly throughout the day is a healthy way of eating CON The Acid Reflux Diet may not improve everyones condition who has acid reflux disease DIET and NUTRITION The Acid Reflux Diet revolves around eating small meals throughout the day rather than three large meals. When large amounts of food are consumed, the stomach is quickly filled and must work extra hard to produce stomach acid for digestion. Adopting a grazing style of eating ensures that the stomach does not get overloaded and that only small quantities of stomach acid are released to digest food. High fat meals or high fat food, particularly from fast-food chains, should be avoided since they tend to stay in the stomach longer. Not consuming alcohol, particularly beer, and soda is necessary since these beverages stimulate acid production in the stomach. Also, as part of the Acid Reflux Diet, you should remain upright for at least 45 minutes after each meal and have your last meal of the day three hours before going to bed. Lying down creates more of an opportunity for stomach acid to regurgitate up into the esophagus. EXERCISE The Acid Reflux Diet does not put forth any specific exercise guidelines; but exercise should not be done right after eating as this creates the potential for stomach acid to travel upwards and incite an acid reflux episode. CONCLUSION Even though there has been conflicting advice on foods to avoid for acid reflux sufferers, The Acid Reflux Diet is a guideline that debunks a lot of the previously held beliefs that specific foods trigger acid reflux disease. This diet rather focuses on a style of eating and lets the individual determine which foods to avoid based upon their own personal experience with this chronic condition.
Enhanced expression of interleukin-8 and activation of nuclear factor kappa-B in endoscopy-negative gastroesophageal reflux disease. Am J Gastroenterol 2004;99:589597.| Article | ChemPort | Liu B, et al. Esophageal dysmotility and the change of synthesis of nitric oxide in a feline esophagitis model. Dis Esoph 2002;15:193198. Paterson WG, Kolyn DM. Esophageal shortening induced by short-term intraluminal acid perfusion in opossum: a cause for hiatus hernia? Gastroenterology 1994;107:17361740.| ChemPort | Paterson WG. Role of mast cell-derived mediators in acid-induced shortening of the esophagus. Am J Physiol 1998;37:G385G388. Zhang Y, Paterson WG. Nitric oxide contracts longitudinal smooth muscle of opossum esophagus via excitation-contraction coupling. J Physiol 2001;536:133140.| Article | ChemPort | Barlow WJ, Orlando RC.
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