[Esophageal motility disorders in patients with esophageal reflux disease without pathologic reflux by 24 h esophageal pH monitoring].
BACKGROUND
In a high proportion of patients with symptomatic gastroesophageal reflux disease, 24 h esophageal pH monitoring is normal.


OBJECTIVE
To study esophageal motility in patients with symptomatic gastroesophageal reflux disease and normal 24 h esophageal pH monitoring.


METHODS
Fourteen patients (12 women, aged 28 to 74 years old) with esophageal reflux disease and normal 24 pH monitoring and 14 asymptomatic controls (8 women, aged 19 to 69 years old), were studied. Symptoms were evaluated using an analog scale and all subjects underwent a barium meal, upper gastrointestinal endoscopy and a standard esophageal manometry.


RESULTS
Lower esophageal sphincter was normal in 11 patients, hypotonic in one and displaced to the thorax in two. Esophageal wave amplitude was lower in patients than in asymptomatic controls (10 to 50 and 13 to 70 mm Hg respectively). The proportion of hypotonic waves was Grade I and II in seven patients, Grade III in three and grade IV in four cases. Four patients had localized aperistalsis (that can be considered normal) and four had more severe forms of aperistalsis, along with severe hypotonia.


CONCLUSIONS
Patients with gastroesophageal reflux disease without alterations in 24 h pH monitoring, have alterations in esophageal motility.
Acevedo
A
A
Departamento de Cirugía del Hospital del Salvador, Instituto de Ciencias Biomédicas (ICBM), Unidad de Patologia, Santiago de Chile.
Espinoza
J
J
D000328:Adult; D000368:Aged; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D013997:Time Factors