Ambulatory esophageal pressure and pH monitoring in patients with high-grade reflux esophagitis.
Using conventional manometry and 24-hr ambulatory pressure and pH monitoring, we investigated esophageal motility and the esophageal motor response to reflux in 11 patients with reflux esophagitis Savary-Miller grade III and IV, and an age- and sex-matched group of 11 healthy controls. The patients had a significantly increased esophageal acid exposure. Conventional manometry showed a significantly decreased LES pressure and distal peristaltic amplitude in patients. The 24-hr monitoring yielded a significant decrease in peristaltic contraction duration and peristaltic propagation velocity in the patient group. Distal peristaltic amplitude was not decreased. Analysis of the contractions occurring in the 2-min period after each reflux episode showed a reduced number of contractions during the upright period, caused by a significantly decreased number of peristaltic contractions. During the supine period, there was a trend towards an increased number of contractions. It is concluded that esophageal motor activity and the response to reflux are impaired in patients with high-grade reflux esophagitis. However, the abnormalities found are only minor and are unlikely to play an important role in the pathogenesis of reflux esophagitis.
Timmer
R
R
Department of Gastroenterology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Breumelhof
R
R
Nadorp
J H
JH
Smout
A J
AJ
D000368:Aged; D000369:Aged, 80 and over; D002940:Circadian Rhythm / Q000502:physiology; D004942:Esophagitis, Peptic / Q000453:epidemiology / Q000503:physiopathology*; D004943:Esophagogastric Junction / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D010528:Peristalsis / Q000502:physiology; D018709:Statistics, Nonparametric