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Comparison of esophageal acid exposure distribution along the esophagus among the different gastroesophageal reflux disease (GERD) groups.
Am J Gastroenterol. 2006 Nov; 101(11):2463-9.AJ

Abstract

BACKGROUND

Patients with nonerosive reflux disease (NERD) have the lowest esophageal acid exposure profile compared with the other gastroesophageal reflux disease (GERD) groups.

AIM

To compare lower esophageal acid exposure recordings 1 cm above the lower esophageal sphincter (LES) with those 6 cm above the LES as well as to determine the characteristics of esophageal acid exposure along the esophagus among the different GERD groups.

METHODS

Patients with classic heartburn symptoms were enrolled into the study. Patients were evaluated by a demographics questionnaire and the validated GERD Symptom Checklist. Upper endoscopy was performed to evaluate the presence of esophageal erosions and Barrett's esophagus (BE). Ambulatory pH testing was performed using a commercially available 4-sensor pH probe with sensors located 5 cm apart. The distal sensor was placed 1 cm above the LES.

RESULTS

Sixty-four patients completed the study. Of those, 21 patients had NERD, 20 had erosive esophagitis (EE), and 23 had BE. All patient groups demonstrated greater esophageal acid exposure 1 cm above the LES than 6 cm above the LES. In NERD and EE, this phenomenon was primarily a result of a higher mean percentage of upright time with pH <4. Unlike patients with EE and BE, those with NERD had very little variation in esophageal acid exposure throughout the esophagus (total and supine).

CONCLUSIONS

ALL GERD groups demonstrated significant greater esophageal acid exposure at the very distal portion of the esophagus, primarily as a result of short upright reflux events. Unlike erosive esophagitis and BE, NERD patients demonstrate a more homogenous acid distribution along the esophagus.

Authors+Show Affiliations

The Neuro-Enteric Clinical Research Group, Department of Medicine, Section of Gastroenterology, Southern Arizona VA Health Care System, Tucson, Arizona 85723-0001, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

17090277

Citation

Dickman, Ram, et al. "Comparison of Esophageal Acid Exposure Distribution Along the Esophagus Among the Different Gastroesophageal Reflux Disease (GERD) Groups." The American Journal of Gastroenterology, vol. 101, no. 11, 2006, pp. 2463-9.
Dickman R, Bautista JM, Wong WM, et al. Comparison of esophageal acid exposure distribution along the esophagus among the different gastroesophageal reflux disease (GERD) groups. Am J Gastroenterol. 2006;101(11):2463-9.
Dickman, R., Bautista, J. M., Wong, W. M., Bhatt, R., Beeler, J. N., Malagon, I., Risner-Adler, S., Lam, K. F., & Fass, R. (2006). Comparison of esophageal acid exposure distribution along the esophagus among the different gastroesophageal reflux disease (GERD) groups. The American Journal of Gastroenterology, 101(11), 2463-9.
Dickman R, et al. Comparison of Esophageal Acid Exposure Distribution Along the Esophagus Among the Different Gastroesophageal Reflux Disease (GERD) Groups. Am J Gastroenterol. 2006;101(11):2463-9. PubMed PMID: 17090277.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of esophageal acid exposure distribution along the esophagus among the different gastroesophageal reflux disease (GERD) groups. AU - Dickman,Ram, AU - Bautista,Jimmy M, AU - Wong,Wai-Man, AU - Bhatt,Rajan, AU - Beeler,Joy N, AU - Malagon,Isaac, AU - Risner-Adler,Sara, AU - Lam,Kwok-Fai, AU - Fass,Ronnie, PY - 2006/11/9/pubmed PY - 2006/12/13/medline PY - 2006/11/9/entrez SP - 2463 EP - 9 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 101 IS - 11 N2 - BACKGROUND: Patients with nonerosive reflux disease (NERD) have the lowest esophageal acid exposure profile compared with the other gastroesophageal reflux disease (GERD) groups. AIM: To compare lower esophageal acid exposure recordings 1 cm above the lower esophageal sphincter (LES) with those 6 cm above the LES as well as to determine the characteristics of esophageal acid exposure along the esophagus among the different GERD groups. METHODS: Patients with classic heartburn symptoms were enrolled into the study. Patients were evaluated by a demographics questionnaire and the validated GERD Symptom Checklist. Upper endoscopy was performed to evaluate the presence of esophageal erosions and Barrett's esophagus (BE). Ambulatory pH testing was performed using a commercially available 4-sensor pH probe with sensors located 5 cm apart. The distal sensor was placed 1 cm above the LES. RESULTS: Sixty-four patients completed the study. Of those, 21 patients had NERD, 20 had erosive esophagitis (EE), and 23 had BE. All patient groups demonstrated greater esophageal acid exposure 1 cm above the LES than 6 cm above the LES. In NERD and EE, this phenomenon was primarily a result of a higher mean percentage of upright time with pH <4. Unlike patients with EE and BE, those with NERD had very little variation in esophageal acid exposure throughout the esophagus (total and supine). CONCLUSIONS: ALL GERD groups demonstrated significant greater esophageal acid exposure at the very distal portion of the esophagus, primarily as a result of short upright reflux events. Unlike erosive esophagitis and BE, NERD patients demonstrate a more homogenous acid distribution along the esophagus. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17090277/Comparison_of_esophageal_acid_exposure_distribution_along_the_esophagus_among_the_different_gastroesophageal_reflux_disease__GERD__groups_ L2 - http://Insights.ovid.com/pubmed?pmid=17090277 DB - PRIME DP - Unbound Medicine ER -