[Esophageal manometry in gastroesophageal reflux disease. Lower esophageal sphincter incompetence or esophageal dismotility?].
BACKGROUND
Hipotensive lower esophageal sphincter (HLES) has been considered the most frequent finding in patients with gastroesophageal reflux disease (GERD). Recently it has been published that esophageal dismotility (ED) has a higher prevalence in GERD.


OBJECTIVE
To compare the prevalence of HLES with ED in patients with GERD.


METHODS
Consecutive patients with endoscopic esophagitis grade II or higher and abnormal esophageal acid exposure time in pH-monitoring were evaluated. Stationary esophageal manometry were performed in all patients. HLES was defined by: a) LES pressure < 10 mmHg, b) LES length < 2 cm and c) LES abdominal segment < 1 cm. ED was defined by: a) presence of more than 30% of peristaltic waves with an amplitude < 30 mmHg or b) more than 10% of simultaneous waves in distal esophagus.


RESULTS
Thirty-seven patients, 27 women and 10 men were evaluated. Twelve patients (32.4%) had ED, 5 (13.5%) showed HLES. Four of these 17 patients had both abnormalities. Fifteen patients (40.5%) had normal findings and in 5 (13.5%) a high LES pressure was found.


CONCLUSIONS
Esophageal dismotility is the most common manometric abnormality in patients with GERD.
Valdovinos Díaz
M A
MA
Departamento de Gastroenterología, Instituto Nacional de la Nutrición Salvador Zubirán, Tlalpan, México D.F.
Flores
C
C
Facha
M T
MT
Koller Lucio
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D015154:Esophageal Motility Disorders / Q000503:physiopathology*; D004943:Esophagogastric Junction / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged