title: [Esophageal motility abnormalities and their impact on esophageal acid exposure in patients with gastroesophageal reflux disease].
abstract: OBJECTIVE
  To identify the characteristics of esophageal motility abnormalities in patients with gastroesophageal reflux disease (GERD) and its influence on esophageal acid exposure.
  
  
  METHODS
  Patients with typical reflux symptoms and diagnosis of reflux esophagitis (RE) or non-erosive reflux disease (NERD), and healthy subject were enrolled in this prospective controlled study. The esophageal manometry and esophageal 26 hours pH monitoring were performed. GERD patients were divided into 3 groups according to their esophageal motility abnormalities: ① low lower esophageal sphincter pressure (LESP) group, ② ineffective esophageal motivation (IEM) group, ③ IEM and low LESP group. Esophageal acid exposure was analyzed among different groups.
  
  
  RESULTS
  A total of 27 GERD patients (15 RE, 12 NERD) and 10 healthy subjects were enrolled in this study. The esophageal motility abnormalities in GERD patients mainly presented as the decrease of LESP and distal esophageal body pressure. The proportion of 3 kinds of esophageal motility abnormalities has significant difference between RE and NERD patients (P = 0.017). In IEM and low LESP group, all patients suffered from RE, with the total number of acid exposure, the total acid exposure time and the acid exposure time in fasting higher than those in low LESP group [98.0 (63.3, 282.8) times vs 41.0 (25.0, 82.0) times, P = 0.029; 11.7% (4.1%, 30.0%) vs 2.2% (1.4%, 9.6%), P = 0.045; 2.6% (0.9%, 4.9%) vs 0.0 (0.0, 1.2%), P = 0.015].
  
  
  CONCLUSIONS
  Esophageal motility abnormalities in GERD patients are characterized as low LESP and IEM in distal esophagus. The coexistence of low LESP and IEM exacerbates esophageal acid exposure, which might explain the mechanism of esophageal mucosal injury in RE patients.
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Yuantao
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, 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, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, 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, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Huijun
authors.initials: H
authors.lastname: Shu
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Guijun
authors.initials: G
authors.lastname: Fei
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, 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, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; Email: fangxiucai2@aliyun.com.
authors.forename: Xiucai
authors.initials: X
authors.lastname: Fang
mesh_terms: D016022:Case-Control Studies; D015154:Esophageal Motility Disorders / Q000503:physiopathology; D050782:Esophageal pH Monitoring; D004947:Esophagus / Q000002:abnormalities*; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008365:Manometry; D011446:Prospective Studies