title: Manometric findings in patients with isolated distal gastroesophageal reflux.
abstract: OBJECTIVE
  To analyze manometric abnormalities in patients with isolated distal reflux and compare these findings in patients with erosive and non-erosive disease.
  
  
  METHODS
  Five hundred and fifty patients who presented to the outpatient clinic of Turkiye Yuksek Ihtisas Hospital with gastroesophageal reflux disease-like symptoms were enrolled. Each individual was evaluated with esophageal manometry, 24-h ambulatory pH monitoring, and upper gastrointestinal endoscopy. Manometric findings for the patients with isolated distal reflux were compared to findings in controls who were free of reflux disorders or hypersensitive esophagus. Findings for isolated distal reflux patients with and without erosive reflux disease were also compared.
  
  
  RESULTS
  Of the 550 subjects enrolled, 97 (17.6%, mean age 48 years) had isolated distal reflux and 100 had no abnormalities on ambulatory pH monitoring (control group, mean age 45 years). There were no significant differences between the isolated distal reflux group and control group with respect to age, body mass index, and esophageal body contraction amplitude (EBCA). Mean lower esophageal sphincter pressure was significantly higher in the control group (12.7 +/- 10.3 mmHg vs 9.6 +/- 7.4 mmHg, P = 0.01). Fifty-five (56.7%) of the 97 patients with isolated distal reflux had erosive reflux disease. There were no statistical differences between the erosive reflux disease and non-erosive reflux disease subgroups with respect to mean EBCA, lower esophageal sphincter pressure, or DeMeester score. However, 13% of patients with gastroesophageal reflux disease had distal wave amplitudes < or = 30 mmHg, whereas none of the patients with non-erosive reflux disease had distal wave amplitudes in this low category.
  
  
  CONCLUSIONS
  Patients with erosive and non-erosive disease present with similar manometric abnormalities. The only striking difference is the observation of very low EBCA exclusively in patients with erosive disease.
authors.affiliation: Gastroenterology Department, Turkey Yuksek Ihtisas Training and Research Hospital, Kizilay Sokak, 06040 Sihhiye, Ankara, Turkey. yoozderin@gmail.com
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Ozin
authors.forename: Ulku
authors.initials: U
authors.lastname: Dagli
authors.forename: Sedef
authors.initials: S
authors.lastname: Kuran
authors.forename: Burhan
authors.initials: B
authors.lastname: Sahin
mesh_terms: D000328:Adult; D050782:Esophageal pH Monitoring; D004945:Esophagoscopy / Q000379:methods; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods; D011312:Pressure; D013997:Time Factors