Gastric emptying and dyspeptic symptoms in patients with gastroesophageal reflux.
OBJECTIVE
To clarify 1) whether gastric emptying of a mixed meal is delayed in patients with gastroesophageal reflux and 2) the relationship between dyspeptic symptoms and delayed gastric emptying in refluxers.


METHODS
Gastric emptying of a solid meal was studied by ultrasound in 25 patients with pathological esophageal acid exposure. Gastric emptying was then assessed in relation to upper digestive endoscopy, esophageal manometry, 24-h pH monitoring and quantification of symptoms of reflux- and dysmotility-like dyspepsia.


RESULTS
Fifteen of 25 refluxers had esophagitis, and 15 were "dyspeptic". Refluxers exhibited a significant delay in gastric emptying compared with controls [307.6 (21.0) vs. 209 (10.4) min, p < 0.001). Patients with delayed emptying had low LES pressure [11.9 (2.1) vs. 18.6 (2.1) mm Hg, p < 0.05]. There was no correlation between delayed emptying and either pH monitoring or presence of esophagitis. There were no differences in any of the pH monitoring parameters between refluxers with and without coexisting dysmotility-like symptoms.


CONCLUSIONS
Gastric emptying of a solid meal is markedly delayed in patients with gastroesophageal reflux. However, no direct causal link was found between delayed emptying and reflux. Our data suggest the presence of a motility disorder in gastroesophageal reflux which is not confined to the esophagogastric junction.
Benini
L
L
Department of Gastroenterology, Rehabilitation Hospital of Verona University in Valeggio SM, Italy.
Sembenini
C
C
Castellani
G
G
Caliari
S
S
Fioretta
A
A
Vantini
I
I
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D013270:Stomach / Q000000981:diagnostic imaging / Q000503:physiopathology; D013997:Time Factors; D014463:Ultrasonography