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Ambulatory esophageal pressure and pH monitoring in patients with high-grade reflux esophagitis

  • Esophageal, Gastric, And Duodenal Disorders
  • Published:
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Abstract

Using conventional manometry and 24-hr ambulatory pressure and pH monitoring, we investigated esophageal motility and the esophageal motor response to reflux in 11 patients with reflux esophagitis Savary-Miller grade III and IV, and an age- and sex-matched group of 11 healthy controls. The patients had a significantly increased esophageal acid exposure. Conventional manometry showed a significantly decreased LES pressure and distal peristaltic amplitude in patients. The 24-hr monitoring yielded a significant decrease in peristaltic contraction duration and peristaltic propagation velocity in the patient group. Distal peristaltic amplitude was not decreased. Analysis of the contractions occurring in the 2-min period after each reflux episode showed a reduced number of contractions during the upright period, caused by a significantly decreased number of peristaltic contractions. During the supine period, there was a trend towards an increased number of contractions. It is concluded that esophageal motor activity and the response to reflux are impaired in patients with high-grade reflux esophagitis. However, the abnormalities found are only minor and are unlikely to play an important role in the pathogenesis of reflux esophagitis.

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References

  1. Kahrilas PJ, Dodds WJ, Hogan WJ, Kern M, Arndorfer RC, Reece A: Esophageal peristaltic dysfunction in peptic esophagitis. Gastroenterology 91:897–904, 1986

    PubMed  Google Scholar 

  2. Katz PO, Knuff TE, Benjamin SB, Castell DO: Abnormal esophageal pressures in reflux esophagitis: Cause or effect? Am J Gastroenterol 81:744–746, 1986

    Google Scholar 

  3. Singh P, Adamopoulos A, Taylor RH, Colin-Jones DG: Oesophageal motor function before and after healing of oesophagitis. Gut 33:1590–1596, 1992

    PubMed  Google Scholar 

  4. Timmer R, Breumelhof R, Nadorp JHSM, Smout AJPM: Esophageal motility in low-grade reflux esophagitis, evaluated by stationary and 24-hour ambulatory manometry. Am J Gastroenterol 88:837–841, 1993

    PubMed  Google Scholar 

  5. Barham CP, Gotley DC, Miller R, Mills A, Alderson D: Pressure events surrounding oesophageal acid reflux episodes and acid clearance in ambulant healthy volunteers. Gut 34:444–449, 1993

    PubMed  Google Scholar 

  6. Timmer R, Breumelhof R, Nadorp JHSM, Smout AJPM: Oesophageal motor response to reflux is not impaired in reflux oesophagitis. Gut 34:317–320, 1993

    PubMed  Google Scholar 

  7. Helm JF, Dodds WJ, Pelc LR, Palmer DW, Hogan WJ, Teeter BC: Effect of esophageal emptying and saliva on clearance of acid from the esophagus. N Engl J Med 310:284–288, 1984

    PubMed  Google Scholar 

  8. Shaker R, Kahrilas PJ, Dodds WJ, Hogan WJ: Oesophageal clearance of small amounts of equal or less than one millitre of acid. Gut 33:7–10, 1992

    PubMed  Google Scholar 

  9. Sloan S, Kahrilas PJ: Impairment of esophageal emptying with hiatal hernia. Gastroenterology 100:596–605, 1991

    PubMed  Google Scholar 

  10. Orlando RC: Pathophysiology of gastroesophageal reflux disease: esophageal resistance.In The Esophagus. DO Castell (ed). Boston, Little, Brown, 1992, pp 463–478

    Google Scholar 

  11. Kahrilas PJ, Dodds WJ, Hogan WJ: Effect of peristaltic dysfunction on esophageal volume clearance. Gastroenterology 94:73–80, 1988

    PubMed  Google Scholar 

  12. Gill RC, Bowes KL, Murphy PD, Kingma YJ: Esophageal motor abnormalities in gastroesophageal reflux and the effect of fundoplication. Gastroenterology 91:364–369, 1986

    PubMed  Google Scholar 

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Timmer, R., Breumelhof, R., Nadorp, J.H.S.M. et al. Ambulatory esophageal pressure and pH monitoring in patients with high-grade reflux esophagitis. Digest Dis Sci 39, 2084–2089 (1994). https://doi.org/10.1007/BF02090354

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  • DOI: https://doi.org/10.1007/BF02090354

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