Esophageal motility in Japanese patients with Barrett's esophagus.
BACKGROUND
The prevalence of gastroesophageal reflux disease has been increasing in Japan as it has in Western countries, but Barrett's esophagus (BE) is less common in Japan than in Western countries. The aim of this study, therefore, was to investigate esophageal motility and clinical characteristics in Japanese patients with BE.


METHODS
Ten patients with BE were compared with ten patients with mild reflux esophagitis (RE), ten patients with severe RE, and ten healthy subjects of comparable age and sex. The prevalence of Helicobacter pylori was investigated in the patients with BE. The intraluminal microtransducer method was used to test for esophageal motility. Basal lower esophageal sphincter (LES) pressure was assessed by the rapid pull-through method. The esophageal wave after ten repeated 5-ml water swallowings at 30-s intervals was measured at 3, 8, 13, and 18 cm above the LES.


RESULTS
The basal LES pressure, the amplitude of the esophageal wave at 3 and 8 cm above the LES, and the frequency of primary peristalsis in the severe RE group and BE group were significantly lower than the values in the healthy subjects and the mild RE group. The amplitude of the esophageal wave 13 cm above the LES in the BE group was significantly lower than that in the healthy subjects and the mild RE group. There was no difference between the severe RE group and the BE group in the basal LES pressure and the amplitude of the esophageal wave. The frequency of primary peristalsis in the BE group, however, was significantly lower than that in the severe RE group. Nine of the ten patients with BE were H. pylori-negative.


CONCLUSIONS
Our conclusions are that esophageal dysmotility in Japanese patients with BE represents an advanced stage of severe RE, and that most Japanese patients with BE are H. pylori-negative.
Iwakiri
Katsuhiko
K
Third Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan.
Sugiura
Toshiaki
T
Hayashi
Yoshinori
Y
Kotoyori
Makoto
M
Kawakami
Akihiko
A
Makino
Hiroshi
H
Nomura
Tsutomu
T
Miyashita
Masao
M
Takubo
Kaiyo
K
Sakamoto
Choitsu
C
D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000150:complications / Q000503:physiopathology*; D015154:Esophageal Motility Disorders / Q000209:etiology / Q000503:physiopathology*; D004942:Esophagitis, Peptic / Q000150:complications / Q000503:physiopathology*; D004943:Esophagogastric Junction / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged