Relevance of ineffective esophageal motility and hyperactive acid sensitization in patients with gastroesophageal reflux.
OBJECTIVE
Esophageal motor abnormalities including ineffective esophageal motility (IEM) and visceral hypersensitivity have been frequently observed in patients with gastroesophageal reflux. The aim of this study was to observe the incidences of hypersensitivity to acid infusion and motor abnormalities in non-erosive reflux disease (NERD) compared with erosive esophagitis.


METHODS
We performed upper GI endoscopy, an acid perfusion test and esophageal manometry on 113 NERD patients and 37 erosive esophagitis patients.


RESULTS
The frequency of acid sensitization was 69.9% in NERD and 67.6% in erosive esophagitis. The frequency of esophageal motor abnormality in patients with erosive esophagitis (48.6%) was higher than in patients with NERD (25.7%, P = 0.014). The most frequent esophageal motor abnormality was IEM. The frequency of IEM was 15.9% in NERD patients, 42.9% in Los Angeles grade A, 53.8% in Los Angeles grade B and 66.7% in Los Angeles grade C esophagitis (chi(2) = 16.67, P < 0.0001).


CONCLUSIONS
Our results suggest that no difference exists between visceral hypersensitivity in patients with NERD and those with erosive esophagitis, and that IEM occurs in NERD as well as erosive esophagitis patients. The occurrence of IEM is associated with the endoscopic severity of gastroesophageal reflux disease.
Hong
Su Jin
SJ
Department of Gastroenterology, Institute for Digestive Research, Soonchunhyang University College of Medicine, Bucheon, Korea.
Ko
Bong Min
BM
Jung
In Seop
IS
Ryu
Chang Beom
CB
Moon
Jong Ho
JH
Cho
Joo Young
JY
Kim
Jin Oh
JO
Lee
Joon Seong
JS
Lee
Moon Sung
MS
Shim
Chan Sup
CS
Kim
Boo Sung
BS
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D016099:Endoscopy, Gastrointestinal; D015154:Esophageal Motility Disorders / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D050782:Esophageal pH Monitoring; D004942:Esophagitis, Peptic / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors