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Pathophysiological characteristics of the various forms of gastro-oesophageal reflux disease. Spectrum disease or distinct phenotypic presentations?
Dig Liver Dis 2006; 38(9):643-8DL

Abstract

BACKGROUND

The traditional approach to gastro-oesophageal reflux disease as a spectrum disease has recently been criticised and the distinct phenotypic presentations model has been proposed.

AIM

To evaluate the main pathophysiological characteristics of various gastro-oesophageal reflux disease presentations.

METHODS

Oesophageal manometry and 24-h pH-monitoring were performed in a gastro-oesophageal reflux disease series collected in a 7-year period.

RESULTS

Four hundred and twenty-one subjects were studied. Mean total percentage acid reflux time was significantly higher in long-segment Barrett's oesophagus and in ulcerative oesophagitis than in all the other gastro-oesophageal reflux disease groups, whilst in short-segment Barrett's oesophagus results were quite similar to those found in non-erosive reflux disease and in erosive reflux disease. Patients with ulcerative oesophagitis and long-segment Barrett's oesophagus were older than all the other gastro-oesophageal reflux disease groups. The mean lower oesophageal sphincter pressure was significantly reduced in non-erosive reflux disease, erosive reflux disease, ulcerative oesophagitis, short-segment Barrett's oesophagus and long-segment Barrett's oesophagus as compared with functional heartburn and hypersensitive oesophagus and with controls.

CONCLUSIONS

In keeping with the spectrum model of gastro-oesophageal reflux disease, severity of acid reflux increases from non-erosive reflux disease through erosive reflux disease up to ulcerative oesophagitis and long-segment Barrett's oesophagus. Ulcerative oesophagitis and long-segment Barrett's oesophagus could represent an advanced step in the natural history of gastro-oesophageal reflux disease. Our results do not confirm the distinct phenotypic presentations hypothesis.

Authors+Show Affiliations

Internal Medicine and Gastroenterology Unit, New S. Agostino Hospital, Via Martignana 51, 41100 Modena, Italy. m.frazzoni@ausl.mo.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16627016

Citation

Frazzoni, M, et al. "Pathophysiological Characteristics of the Various Forms of Gastro-oesophageal Reflux Disease. Spectrum Disease or Distinct Phenotypic Presentations?" Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 38, no. 9, 2006, pp. 643-8.
Frazzoni M, Manno M, De Micheli E, et al. Pathophysiological characteristics of the various forms of gastro-oesophageal reflux disease. Spectrum disease or distinct phenotypic presentations? Dig Liver Dis. 2006;38(9):643-8.
Frazzoni, M., Manno, M., De Micheli, E., & Savarino, V. (2006). Pathophysiological characteristics of the various forms of gastro-oesophageal reflux disease. Spectrum disease or distinct phenotypic presentations? Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 38(9), pp. 643-8.
Frazzoni M, et al. Pathophysiological Characteristics of the Various Forms of Gastro-oesophageal Reflux Disease. Spectrum Disease or Distinct Phenotypic Presentations. Dig Liver Dis. 2006;38(9):643-8. PubMed PMID: 16627016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathophysiological characteristics of the various forms of gastro-oesophageal reflux disease. Spectrum disease or distinct phenotypic presentations? AU - Frazzoni,M, AU - Manno,M, AU - De Micheli,E, AU - Savarino,V, Y1 - 2006/04/14/ PY - 2006/01/09/received PY - 2006/02/22/revised PY - 2006/02/28/accepted PY - 2006/4/22/pubmed PY - 2007/1/11/medline PY - 2006/4/22/entrez SP - 643 EP - 8 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 38 IS - 9 N2 - BACKGROUND: The traditional approach to gastro-oesophageal reflux disease as a spectrum disease has recently been criticised and the distinct phenotypic presentations model has been proposed. AIM: To evaluate the main pathophysiological characteristics of various gastro-oesophageal reflux disease presentations. METHODS: Oesophageal manometry and 24-h pH-monitoring were performed in a gastro-oesophageal reflux disease series collected in a 7-year period. RESULTS: Four hundred and twenty-one subjects were studied. Mean total percentage acid reflux time was significantly higher in long-segment Barrett's oesophagus and in ulcerative oesophagitis than in all the other gastro-oesophageal reflux disease groups, whilst in short-segment Barrett's oesophagus results were quite similar to those found in non-erosive reflux disease and in erosive reflux disease. Patients with ulcerative oesophagitis and long-segment Barrett's oesophagus were older than all the other gastro-oesophageal reflux disease groups. The mean lower oesophageal sphincter pressure was significantly reduced in non-erosive reflux disease, erosive reflux disease, ulcerative oesophagitis, short-segment Barrett's oesophagus and long-segment Barrett's oesophagus as compared with functional heartburn and hypersensitive oesophagus and with controls. CONCLUSIONS: In keeping with the spectrum model of gastro-oesophageal reflux disease, severity of acid reflux increases from non-erosive reflux disease through erosive reflux disease up to ulcerative oesophagitis and long-segment Barrett's oesophagus. Ulcerative oesophagitis and long-segment Barrett's oesophagus could represent an advanced step in the natural history of gastro-oesophageal reflux disease. Our results do not confirm the distinct phenotypic presentations hypothesis. SN - 1590-8658 UR - https://www.unboundmedicine.com/medline/citation/16627016/Pathophysiological_characteristics_of_the_various_forms_of_gastro_oesophageal_reflux_disease__Spectrum_disease_or_distinct_phenotypic_presentations L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(06)00074-0 DB - PRIME DP - Unbound Medicine ER -