title: Gastroesophageal reflux in cirrhotic patients without esophageal varices.
abstract: OBJECTIVE
  To evaluate the esophageal motility and abnormal acid and bile reflux incidence in cirrhotic patients without esophageal varices (EV).
  
  
  METHODS
  Seventy-eight patients with liver cirrhosis without EV confirmed by upper gastroesophageal endoscopy and 30 healthy control volunteers were prospectively enrolled in this study. All the patients were evaluated using a modified protocol including Child-Pugh score, upper gastrointestinal endoscopy, esophageal manometry, simultaneous ambulatory 24-h esophageal pH and bilirubin monitoring. All the patients and volunteers accepted the manometric study.
  
  
  RESULTS
  In the liver cirrhosis group, lower esophageal sphincter pressure (LESP, 15.32 ± 2.91 mmHg), peristaltic amplitude (PA, 61.41 ± 10.52 mmHg), peristaltic duration (PD, 5.32 ± 1.22 s), and peristaltic velocity (PV, 5.22 ± 1.11 cm/s) were all significantly abnormal in comparison with those in the control group (P < 0.05), and LESP was negatively correlated with Child-Pugh score. The incidence of reflux esophagitis (RE) and pathologic reflux was 37.18% and 55.13%, respectively (vs. control, P < 0.05). And the incidence of isolated abnormal acid reflux, bile reflux and mixed reflux was 12.82%, 14.10% and 28.21% in patients with liver cirrhosis without EV.
  
  
  CONCLUSIONS
  Cirrhotic patients without EV presented esophageal motor disorders and mixed acid and bile reflux was the main pattern; the cirrhosis itself was an important causative factor.
authors.affiliation: Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Pei-Lin
authors.initials: PL
authors.lastname: Cui
authors.forename: Dong
authors.initials: D
authors.lastname: Lv
authors.forename: Shi-Wei
authors.initials: SW
authors.lastname: Yao
authors.forename: You-Qing
authors.initials: YQ
authors.lastname: Xu
authors.forename: Zhao-Xu
authors.initials: ZX
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000378:metabolism; D015154:Esophageal Motility Disorders / Q000209:etiology* / Q000503:physiopathology; D004932:Esophageal and Gastric Varices / Q000209:etiology*; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D055815:Young Adult
chemical_list: D001663:Bilirubin