title: Upper esophageal sphincter motility in gastroesophageal reflux disease in the light of the high-resolution manometry.
abstract: This study aims to evaluate the upper esophageal sphincter (UES) motility in patients with gastroesophageal reflux disease (GERD) as compared to healthy volunteers. We retrospectively studied the HRM tests of 44 patients (median age: 61 years, 54% females) under evaluation for GERD. The manometric UES parameters of these patients were compared to 40 healthy volunteers (median age: 27 years, 50% females). Almost half of the patients had a short and hypotonic UES. Patients with extraesophageal symptoms had a higher proportion of hypotonic UES as compared to patients with esophageal symptoms. Reflux pattern did not influence manometric parameters. Proximal reflux (any number of episodes) was present in 37(84%) patients (median number of proximal episodes = 6). Manometric parameters are similar in the presence or absence of proximal reflux. There is not a correlation between the UES length and UES basal pressure. In conclusion, our results show that: (1) the manometric profile of the UES in patients with GERD is characterized by a short and hypotonic UES in half of the patients; (2) this profile is more pronounced in patients with extraesophageal symptoms; and (3) neither the presence of proximal reflux nor reflux pattern bring a different manometric profile.
authors.affiliation: Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: B F
authors.initials: BF
authors.lastname: Nadaleto
authors.affiliation: Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: F A M
authors.initials: FA
authors.lastname: Herbella
authors.affiliation: Department of Ear, Nose and Throat, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: B R
authors.initials: BR
authors.lastname: Pinna
authors.affiliation: Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Patti
mesh_terms: D016022:Case-Control Studies; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies
keywords: gastroesophageal reflux; manometry; motility; upper esophageal sphincter