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Differences in esophageal corpus motility in patients with pathological and non-pathological gastroesophageal reflux.
Med Sci Monit. 2006 Sep; 12(9):CR387-92.MS

Abstract

BACKGROUND

First- and second-order esophageal contractions are important factors responsible for esophageal clearance of refluxed gastric content. The aim of this study was to estimate the influence of acid reflux on second-order esophageal peristalsis.

MATERIAL/METHODS

Simultaneous 24-h esophageal pH-metry and 24-h motility monitoring was performed in 213 patients with non-cardiac chest pain. Pathological gastroesophageal acid reflux (pGER) was defined as pH <4 for more than 4.5% of the total monitoring time.

RESULTS

The group of pGER patients (n=65, 31%) had a lower percentage of complete and effective peristalsis, a higher percentage of incomplete peristalsis, and a lower mean contraction amplitude than the group of patients with normal esophageal acid exposure (nGER). Analysis of motility parameters in three periods, i.e. during acid reflux and 2 min before and 10 min after episodes (second-order peristalsis), showed that the pGER group had a lower percentage of effective peristalsis (20.6 +/- 13.3 vs. 29.6 +/- 16.2%, p = 0.002) and a higher percentage of ineffective peristalsis both during and after acid reflux, a lower mean contraction amplitude (56.5 +/- 30.3 vs. 70.0 +/- 32.8 mmHg, p=0.025), and a lower contraction frequency during acid reflux (1.6 +/- 0.7 vs. 2.6 +/- 3.1/min, p=0.001) and 10 min after (1.9 +/- 1.9 vs. 20.6 +/- 30.2/min, p=0.002), which indicated a lack of esophageal peristalsis acceleration after acid reflux in the pGER group.

CONCLUSIONS

(1) pGER patients had ineffective esophageal peristalsis more frequently than nGER patients. (2) Impaired second-order peristalsis in pGER patients may be an important factor determining prolonged exposure of the esophageal mucosa to gastric content in addition to lower esophageal sphincter function.

Authors+Show Affiliations

Department of Gastroenterology, Vascular Diseases, and Internal Medicine, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Poland. mariaklopocka@wp.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16940933

Citation

Klopocka, Maria, et al. "Differences in Esophageal Corpus Motility in Patients With Pathological and Non-pathological Gastroesophageal Reflux." Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, vol. 12, no. 9, 2006, pp. CR387-92.
Klopocka M, Budzyński J, Swiatkowski M, et al. Differences in esophageal corpus motility in patients with pathological and non-pathological gastroesophageal reflux. Med Sci Monit. 2006;12(9):CR387-92.
Klopocka, M., Budzyński, J., Swiatkowski, M., Pulkowski, G., & Meder, A. (2006). Differences in esophageal corpus motility in patients with pathological and non-pathological gastroesophageal reflux. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 12(9), CR387-92.
Klopocka M, et al. Differences in Esophageal Corpus Motility in Patients With Pathological and Non-pathological Gastroesophageal Reflux. Med Sci Monit. 2006;12(9):CR387-92. PubMed PMID: 16940933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in esophageal corpus motility in patients with pathological and non-pathological gastroesophageal reflux. AU - Klopocka,Maria, AU - Budzyński,Jacek, AU - Swiatkowski,Maciej, AU - Pulkowski,Grzegorz, AU - Meder,Agnieszka, PY - 2003/12/09/received PY - 2005/02/12/accepted PY - 2006/8/31/pubmed PY - 2007/1/11/medline PY - 2006/8/31/entrez SP - CR387 EP - 92 JF - Medical science monitor : international medical journal of experimental and clinical research JO - Med Sci Monit VL - 12 IS - 9 N2 - BACKGROUND: First- and second-order esophageal contractions are important factors responsible for esophageal clearance of refluxed gastric content. The aim of this study was to estimate the influence of acid reflux on second-order esophageal peristalsis. MATERIAL/METHODS: Simultaneous 24-h esophageal pH-metry and 24-h motility monitoring was performed in 213 patients with non-cardiac chest pain. Pathological gastroesophageal acid reflux (pGER) was defined as pH <4 for more than 4.5% of the total monitoring time. RESULTS: The group of pGER patients (n=65, 31%) had a lower percentage of complete and effective peristalsis, a higher percentage of incomplete peristalsis, and a lower mean contraction amplitude than the group of patients with normal esophageal acid exposure (nGER). Analysis of motility parameters in three periods, i.e. during acid reflux and 2 min before and 10 min after episodes (second-order peristalsis), showed that the pGER group had a lower percentage of effective peristalsis (20.6 +/- 13.3 vs. 29.6 +/- 16.2%, p = 0.002) and a higher percentage of ineffective peristalsis both during and after acid reflux, a lower mean contraction amplitude (56.5 +/- 30.3 vs. 70.0 +/- 32.8 mmHg, p=0.025), and a lower contraction frequency during acid reflux (1.6 +/- 0.7 vs. 2.6 +/- 3.1/min, p=0.001) and 10 min after (1.9 +/- 1.9 vs. 20.6 +/- 30.2/min, p=0.002), which indicated a lack of esophageal peristalsis acceleration after acid reflux in the pGER group. CONCLUSIONS: (1) pGER patients had ineffective esophageal peristalsis more frequently than nGER patients. (2) Impaired second-order peristalsis in pGER patients may be an important factor determining prolonged exposure of the esophageal mucosa to gastric content in addition to lower esophageal sphincter function. SN - 1234-1010 UR - https://www.unboundmedicine.com/medline/citation/16940933/Differences_in_esophageal_corpus_motility_in_patients_with_pathological_and_non_pathological_gastroesophageal_reflux_ L2 - https://www.medscimonit.com/download/index/idArt/455251 DB - PRIME DP - Unbound Medicine ER -