Impaired gastric motility and its relationship to reflux symptoms in patients with nonerosive gastroesophageal reflux disease.
BACKGROUND
More than half of patients with refluxrelated symptoms have no endoscopic evidence of mucosal breaks. These patients are considered to have nonerosive gastroesophageal reflux disease (NERD). The pathogenesis of NERD may be multifactorial, but the role played by gastric motility in symptom generation in patients with NERD has not been examined. In this study, we elucidate gastric motility in patients with NERD and the efficacy of a prokinetic agent in the treatment of NERD.


METHODS
Gastric motility was evaluated with electrogastrography (EGG) and by measurement of gastric emptying using the acetaminophen method in 26 patients with NERD and in 11 matched healthy controls. NERD patients were treated with a prokinetic agent (mosapride 15 mg, orally three times daily) for a period of 4 weeks, after which gastric motility was measured again.


RESULTS
Compared with the healthy controls, the NERD patients showed a significantly lower percentage of normogastria, a lower power ratio in EGG, and delayed gastric emptying. Ten patients had normal gastric motor function (group A), and 16 showed abnormalities of either gastric myoelectrical activity or gastric emptying (group B). After treatment with mosapride, gastric motility improved significantly in both groups of patients compared with pretreatment values. The subjective assessment by the patient after the treatment was improved in 20.0% of group A versus 62.5% of group B patients (P < 0.05).


CONCLUSIONS
Gastric hypomotility appears to be an important factor in reflux symptom generation in some NERD patients.
Kamiya
Takeshi
T
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho, Mizuho-ku, Nagoya, 467-8601, Japan.
Adachi
Hiroshi
H
Hirako
Makoto
M
Shikano
Michiko
M
Matsuhisa
Eriko
E
Wada
Tsuneya
T
Ogasawara
Naotaka
N
Nojiri
Shunsuke
S
Kataoka
Hiromi
H
Sasaki
Makoto
M
Ohara
Hirotaka
H
Joh
Takashi
T
D000082:Acetaminophen / Q000493:pharmacokinetics; D000328:Adult; D001549:Benzamides / Q000627:therapeutic use*; D004576:Electromyography / Q000379:methods; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000503:physiopathology; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*
D001549:Benzamides; D005765:Gastrointestinal Agents; D009025:Morpholines; D000082:Acetaminophen; C062720:mosapride