title: Specific movement of esophagus during transient lower esophageal sphincter relaxation in gastroesophageal reflux disease.
abstract: OBJECTIVE
  Transient lower esophageal sphincter relaxation (TLESR) is the main mechanism of gastroesophageal reflux disease (GERD). The aim of this study was to investigate the characteristics of transient lower esophageal sphincter movement in patients with or without gastroesophageal reflux by high-resolution manometry (HRM).
  
  
  METHODS
  From June 2010 to July 2010, we enrolled 9 patients with GERD (GERD group) and 9 subjects without GERD (control group), prospectively. The manometry test was performed in a semi-recumbent position for 120 minutes following ingestion of a standardized, mixed liquid and solid meal. HRM was used to identify the frequency and duration of TLESR, esophageal shortening length from incomplete TLESR, upper esophageal sphincter (UES) response, and the related esophageal motor responses during TLESR.
  
  
  RESULTS
  TLESR occurred in 33 in the GERD group and 34 in the control group after 120 minutes following food ingestion. Duration of TLESR and length of esophageal shortening did not differ between 2 groups. UES pressure increase during TLESR was mostly detected in patients with GERD, and UES relaxation was observed frequently in the control group during TLESR. TLESR-related motor responses terminating in TLESR were predominantly observed in the control group.
  
  
  CONCLUSIONS
  Increased UES pressure was noted frequently in the GERD group, suggesting a mechanism for preventing harmful reflux, which may be composed mainly of fluid on the larynx or pharynx. However, patients with GERD lacked the related motor responses terminating in TLESR to promote esophageal emptying of refluxate.
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Gyeonggi-do, Korea.
authors.forename: Hoon Il
authors.initials: HI
authors.lastname: Kim
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
authors.forename: Jae Pil
authors.initials: JP
authors.lastname: Han
authors.forename: Jung Yeon
authors.initials: JY
authors.lastname: Seo
authors.forename: Kyoung Hwa
authors.initials: KH
authors.lastname: Hwang
authors.forename: Hyo Jin
authors.initials: HJ
authors.lastname: Maeng
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Lee
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Lee
keywords: Gastroesophageal reflux; Manometry; Transient lower esophageal sphincter relaxation