title: [Characteristics of esophageal motility in patients with non-erosive reflux disease and reflux esophagitis].
abstract: OBJECTIVE
  To explore the characteristics of esophageal motility in patients with non-erosive disease (NERD) and reflux esophagitis (RE).
  
  
  METHODS
  For this single-blind retrospective study, adult patients with typical reflux symptoms underwent esophageal manometry from January 2008 to December 2011. Their course of disease, age, gender, esophageal manometry, hiatal function and 24 h pH monitoring were analyzed by univariate and binary Logistic regression analyses.
  
  
  RESULTS
  A total of 244 adult patients (RE = 85, NERD = 159) were enrolled into this study. Age and course of disease were significantly higher in RE group than those in NERD group ((50.7 ± 1.2) vs (46.5 ± 0.9) yrs,(4.8 ± 0.5) vs (3.4 ± 0.3) yrs, both P < 0.05) while no difference existed in gender (P > 0.05).Lower esophageal sphincter (LES) length, LES pressure, peristaltic contraction amplitude of distal esophageal body and rate of effective peristaltic contraction of distal esophageal body were significantly lower in RE group than those in NERD group ((1.91 ± 0.06) vs (2.19 ± 0.04) cm,(6.98 ± 0.31) vs (8.54 ± 0.31)mmHg,(56.76 ± 3.21) vs (75.57 ± 3.47) mmHg, 54.1% (46/85) vs 76.1% (121/159), all P < 0.05) . However, there was no inter-group difference in LES relaxation rate and upper esophageal sphincter (UES) function (both P > 0.05). Rate of hiatal hernia (HH) and hiatal flabby (HF) in RE group significantly increased versus NERD group (23.5% (20/85) vs 1.9% (3/159), 24.7% (21/85) vs 11.3% (18/159), both P < 0.05) . Positive rate of 24 h esophageal pH monitoring, reflux number and percent of reflux were significantly higher in RE group than those in NERD group (59.1% (26/44) vs 32.5% (38/117), 71.0 (13.5, 119.0) vs 25.0 (8.0, 56.0), 5.0% (0.4%, 10.9%) vs 1.1% (0.2%, 5.0%), all P < 0.05) . Binary Logistic regression analysis showed that LES length, rate of effective peristaltic contraction of distal esophageal body and HH were risk factors for RE (OR = 2.781,0.037, 21.722, 95%CI:1.057-7.313, 0.009-0.152, 5.433-86.845).
  
  
  CONCLUSIONS
  Impaired anti-reflux barrier at esophagogastric junction and impaired clearance of esophageal body are important causative factors for RE. And abnormal anatomy in esophagogastric junction should raise alerts.
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Meiyun
authors.initials: M
authors.lastname: Ke
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Xiucai
authors.initials: X
authors.lastname: Fang
mesh_terms: D050782:Esophageal pH Monitoring; D004941:Esophagitis / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology*; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006551:Hernia, Hiatal; D006801:Humans; D008365:Manometry; D008875:Middle Aged; D012189:Retrospective Studies; D016037:Single-Blind Method