title: Motility characteristics in the transition zone in Gastroesophageal Reflux Disease (GORD) patients.
abstract: BACKGROUND
  Defects in distal oesophageal peristalsis was thought to be an indication of incomplete bolus transit (BT). However, the role of transition zone (TZ) defects in the BT in gastroesophageal reflux disease (GORD) patients needs clarification. The aim of this study was to assess the TZ defects in GORD patients and to explore the relationship between TZ defects and BT.
  
  
  METHODS
  One hundred and two patients with reflux symptoms and 20 healthy adults were included in the study. All subjects underwent upper gastrointestinal endoscopy, high resolution impedance manometry (HRiM) and 24-h ambulatory multichannel impedance-pH (MII-pH) monitoring. Patients were subgrouped into reflux oesophagitis (RE), non-erosive reflux disease (NERD), hypersensitive oesophagus (HO) and functional heartburn (FH) classified following MII-pH monitoring. Oesophageal pressure topography was analysed to define TZ defects by spatial or temporal TZ measurements exceeding 2 cm or 1 s, weak and fragmented swallows were excluded, and the association between TZ and BT was investigated.
  
  
  RESULTS
  Following liquid swallows, there were no significant differences in TZ delay time and TZ length between groups (RE: 1.75 s (1.32-2.17) and 2.50 cm (2.40-3.20); NERD: 1.60 s (1.10-2.00) and 2.20 cm (2.10-2.65); HO: 1.60 s (1.30-1.80) and 2.70 cm (2.30-3.00); FH: 1.55 s (1.20-2.17) and 3.10 cm (2.25-5.00); Healthy volunteers: 1.50 s (1.20-1.90) and 2.30 cm (2.10-3.00). However, individuals with TZ defects had lower complete BT rates compared with those without TZ defects (p < 0.001). There were also significantly more incomplete BT in patients with RE, HO and FH than in healthy controls (p < 0.05).
  
  
  CONCLUSIONS
  In GORD patients, TZ defects correlated with proximal bolus retention in the corresponding area independent of distal weak peristalsis.
authors: Department of Gastroenterology, First affiliated Hospital, Sun Yat-sen University, Guangzhou, GuangDong Province, 510080, People's Republic of China.|Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, 4102, Australia.
authors: Yu-Wen
authors: YW
authors: Li
authors: Department of Gastroenterology, First affiliated Hospital, Sun Yat-sen University, Guangzhou, GuangDong Province, 510080, People's Republic of China.
authors: Chen-Xi
authors: CX
authors: Xie
authors: Gastrointestinal Surgery Center, First affiliated Hospital, Sun Yat-sen University, Guangzhou, GuangDong Province, 510080, People's Republic of China.
authors: Kai-Ming
authors: KM
authors: Wu
authors: Department of Gastroenterology, First affiliated Hospital, Sun Yat-sen University, Guangzhou, GuangDong Province, 510080, People's Republic of China. chenminhu@vip.163.com.
authors: Min-Hu
authors: MH
authors: Chen
authors: Department of Gastroenterology, First affiliated Hospital, Sun Yat-sen University, Guangzhou, GuangDong Province, 510080, People's Republic of China. yinglian.xiao@gmail.com.
authors: Ying-Lian
authors: YL
authors: Xiao
mesh_terms: D000328:Adult; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D004943:Esophagogastric Junction / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis / Q000502:physiology*; D013997:Time Factors
keywords: Bolus transit; Gastroesophageal reflux disease; High-resolution Impedance manometry; Transition zone