title: Esophageal manometry and 24-h esophageal pH-metry in a large sample of patients with respiratory symptoms.
abstract: OBJECTIVE
  To determine the prevalence of gastroesophageal reflux disease (GERD) and to evaluate the esophageal motor profile of patients with respiratory symptoms referred to a digestive motility referral center for esophageal function testing.
  
  
  METHODS
  The results of esophageal manometry and 24-h esophageal pH-metry were analyzed.The inclusion criterion was presenting respiratory symptoms, with or without accompanying digestive symptoms.
  
  
  RESULTS
  Of the 1,170 patients included in the study, 602 (51.5%) reported having digestive and respiratory symptoms (DRS group), and 568 (48.5%) reported having only respiratory symptoms (RS group). Asthma was diagnosed in 142 patients in the RS group (RS-A subgroup) and in 201 of those in the DRS group (DRS-A). Of the 346 cases of esophageal dysmotility, hypomotility was found in 175 (14.3% and 15.6% in the DRS and RS groups, respectively), and lower esophageal sphincter (LES) hypotonia was found in 411 (40.3% and 30.2%, respectively). Hypotonia correlated with GERD. Exposure of the distal esophagus to acid was markedly abnormal in the supine position. The prevalence of GERD in the sample as a whole, the RS-A/DRS-A subgroups and the RS-A subgroup alone was 39.8%, 44.0% and 35.2%, respectively
  
  
  CONCLUSIONS
  Hypotonic LES was the most common abnormality and correlated with GERD. Although GERD was more evident in the DRS group, approximately one third of the patients in the RS group also presented GERD (silent GERD). The findings suggest that GERD can be an extrapulmonary cause of chronic respiratory symptoms unresponsive to conventional therapy.
authors.affiliation: Laboratório de Motilidade Digestiva, Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Mirna da Mota
authors.initials: Mda M
authors.lastname: Machado
authors.forename: Paulo Francisco Guerreiro
authors.initials: PF
authors.lastname: Cardoso
authors.forename: Iana Oliveira E Silva
authors.initials: IO
authors.lastname: Ribeiro
authors.forename: Idílio
authors.initials: I
authors.lastname: Zamin Júnior
authors.forename: Rene Jacobsen
authors.initials: RJ
authors.lastname: Eilers
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D015154:Esophageal Motility Disorders / Q000175:diagnosis; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology; D050782:Esophageal pH Monitoring; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008365:Manometry; D009123:Muscle Hypotonia / Q000175:diagnosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology