title: What is the real impairment on esophageal motility in patients with gastroesophageal reflux disease?
abstract: BACKGROUND
  Impairment of esophageal motility is a common finding in patients with gastroesophageal reflux disease (GERD) as reduced lower esophageal sphincter (LES) basal pressure. A very low LES pressure might facilitate the occurrence of more gastroesophageal reflux whereas abnormal esophageal peristalsis may contribute to impaired esophageal clearance after reflux.
  
  
  OBJECTIVE
  Evaluate the esophageal motor function of the lower esophageal sphincter and esophageal body in the various forms of gastroesophageal reflux disease.
  
  
  METHODS
  The manometrics records of 268 patients, who had evaluation of the esophageal motility as part of the diagnostic gastroesophageal reflux disease were split into four groups, as follows: 33 patients who had no esophagitis; 92 patients who had erosive esophagitis; 101 patients who had short Barrett's esophagus and 42 patients who had long Barrett's esophagus.
  
  
  RESULTS
  The group who had long Barrett's esophagus showed smaller mean LES pressure and higher percentage of marked LES hypotonia; in the distal segment of the esophageal body the this group showed higher percentage of marked hypocontractility of the distal segment (<30 mm Hg); this same group showed higher percentage of esophageal motility disorders.
  
  
  CONCLUSIONS
  The most intense esophageal motility disorders and lower pressure of lower esophageal sphincter were noted in the group with long Barrett's esophagus. Those with reflux esophagitis and short Barrett's esophagus had esophageal motility impairment, intermediate among patients with esophagitis and long Barrett's esophagus. Patients with typical symptoms of gastroesophageal reflux but without esophagitis by endoscopy study showed no impairment of esophageal motility.
authors.affiliation: Esophageal Surgery Service, Digestive Surgery Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP), São Paulo, SP, Brazil. angelacfalcao@terra.com.br
authors.forename: Angela
authors.initials: A
authors.lastname: Falcão
authors.forename: Ary
authors.initials: A
authors.lastname: Nasi
authors.forename: Jeovana
authors.initials: J
authors.lastname: Brandão
authors.forename: Rubens
authors.initials: R
authors.lastname: Sallum
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000328:Adult; D001471:Barrett Esophagus / Q000150:complications*; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D004941:Esophagitis / Q000150:complications*; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies