title: Impaired esophageal bolus transit in patients with gastroesophageal reflux disease and abnormal esophageal Acid exposure.
abstract: OBJECTIVE
  We assessed the bolus transit and motility characteristics in gastroesophageal reflux disease (GERD) patients with abnormal esophageal pH monitoring.
  
  
  METHODS
  We retrospectively reviewed the combined impedance-esophageal manometry data from consecutive patients who had abnormal acid exposure during 24-hour esophageal pH monitoring. We compared these data to the results from functional heartburn (FH) and asymptomatic volunteers.
  
  
  RESULTS
  The data from 33 GERD patients (mean age of 51 years, 18 males), 14 FH patients (mean age of 51 years, one male), and 20 asymptomatic volunteers (mean age of 27 years, nine males) were analyzed. Ineffective esophageal motility was diagnosed in 10% of the volunteers, 21% of the FH patients, and 15% of the GERD patients. Ineffective contraction was more frequent in GERD and FH patients than in volunteers (16% and 20% vs 6%, respectively; p<0.05). Additionally, 10% of the volunteers, 21% of the FH patients and 36% of the GERD patients had an abnormal bolus transit. Complete bolus transit was less frequent, and bolus transit was slower in GERD patients than in volunteers for liquid (70% vs 85%) and viscous swallows (57% vs 73%). A longer acid clearance time was associated with abnormal bolus transit in the GERD group.
  
  
  CONCLUSIONS
  Patients with GERD have mild peristaltic dysfunction and incomplete and slower esophageal bolus transit. These conditions predispose them to prolonged acid contact with the esophagus.
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Yu Kyung
authors.initials: YK
authors.lastname: Cho
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.forename: Chul Hyun
authors.initials: CH
authors.lastname: Lim
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Kim
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Park
authors.forename: In Seok
authors.initials: IS
authors.lastname: Lee
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Kyu-Yong
authors.initials: KY
authors.lastname: Choi