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Impedance-high resolution manometry analysis of patients with nonerosive reflux disease.
Clin Gastroenterol Hepatol. 2014 Jan; 12(1):52-7.CG

Abstract

BACKGROUND & AIMS

Transient lower esophageal sphincter relaxations (TLESRs) contribute to episodes of reflux. Few studies have assessed the frequencies or compositions of TLESRs and reflux episodes in patients with reflux disease. We used combined high-resolution manometry and impedance monitoring to analyze reflux episodes and esophageal motility in these patients, compared with those of healthy individuals.

METHODS

We evaluated the frequency of TLESRs and the relationship between the reflux pattern and esophageal pressures during TLESRs in 14 patients with nonerosive reflux disease (NERD) and 11 controls. Study participants underwent combined high-resolution manometry and impedance monitoring before and 60 minutes after a solid and liquid meal. The diagnosis of NERD was confirmed by a 24-hour pH impedance test.

RESULTS

The frequency of TLESRs did not differ between patients with NERD and controls. In patients with NERD, TLESRs were associated more often with reflux episodes than in controls (93% ± 6% vs 66% ± 19%; P < .05). Patients with NERD had a higher percentage of pure liquid reflux episodes (33% ± 15% vs 10% ± 2%; P < .05), whereas controls had a higher percentage of mixed reflux episodes (45% ± 16% vs 67% ± 17% in patients with NERD; P < .05). Patients with NERD also had a higher percentage of reflux (liquid and mixed) associated with common cavities (74% ± 18% vs 50% ± 20% in controls; P < .05).

CONCLUSIONS

In contrast to previous studies, we found that TLESRs are associated more often with reflux in patients with NERD than control subjects; this association increases when only liquid and mixed refluxes are considered. These findings indicate that factors involved in the occurrence of reflux in patients with NERD during TLESRs are different from those in healthy subjects.

Authors+Show Affiliations

Department of Digestive Disease, University Campus Bio Medico, Rome, Italy. Electronic address: m.ribolsi@unicampus.it.Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Discipline of Medicine, University of Adelaide, Adelaide, South Australia.Department of Digestive Disease, University Campus Bio Medico, Rome, Italy.Department of Digestive Disease, University Campus Bio Medico, Rome, Italy.Department of Digestive Disease, University Campus Bio Medico, Rome, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23891920

Citation

Ribolsi, Mentore, et al. "Impedance-high Resolution Manometry Analysis of Patients With Nonerosive Reflux Disease." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 12, no. 1, 2014, pp. 52-7.
Ribolsi M, Holloway RH, Emerenziani S, et al. Impedance-high resolution manometry analysis of patients with nonerosive reflux disease. Clin Gastroenterol Hepatol. 2014;12(1):52-7.
Ribolsi, M., Holloway, R. H., Emerenziani, S., Balestrieri, P., & Cicala, M. (2014). Impedance-high resolution manometry analysis of patients with nonerosive reflux disease. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 12(1), 52-7. https://doi.org/10.1016/j.cgh.2013.06.034
Ribolsi M, et al. Impedance-high Resolution Manometry Analysis of Patients With Nonerosive Reflux Disease. Clin Gastroenterol Hepatol. 2014;12(1):52-7. PubMed PMID: 23891920.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impedance-high resolution manometry analysis of patients with nonerosive reflux disease. AU - Ribolsi,Mentore, AU - Holloway,Richard H, AU - Emerenziani,Sara, AU - Balestrieri,Paola, AU - Cicala,Michele, Y1 - 2013/07/23/ PY - 2013/04/04/received PY - 2013/06/11/revised PY - 2013/06/28/accepted PY - 2013/7/30/entrez PY - 2013/7/31/pubmed PY - 2014/8/29/medline KW - AET KW - Acid KW - Esophagus KW - GERD KW - Gastroesophageal Junction KW - HRM KW - LES KW - MI KW - NERD KW - PPI KW - Pressure Gradient KW - Reflux Episodes KW - SAP KW - TLESR KW - TSPG KW - acid exposure time KW - gastroesophageal reflux disease KW - high-resolution manometry KW - lower esophageal sphincter KW - multichannel impedance KW - nonerosive reflux disease KW - proton pump inhibitor KW - symptom association probability KW - trans-sphincteric pressure gradient KW - transient lower esophageal sphincter relaxation SP - 52 EP - 7 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 12 IS - 1 N2 - BACKGROUND & AIMS: Transient lower esophageal sphincter relaxations (TLESRs) contribute to episodes of reflux. Few studies have assessed the frequencies or compositions of TLESRs and reflux episodes in patients with reflux disease. We used combined high-resolution manometry and impedance monitoring to analyze reflux episodes and esophageal motility in these patients, compared with those of healthy individuals. METHODS: We evaluated the frequency of TLESRs and the relationship between the reflux pattern and esophageal pressures during TLESRs in 14 patients with nonerosive reflux disease (NERD) and 11 controls. Study participants underwent combined high-resolution manometry and impedance monitoring before and 60 minutes after a solid and liquid meal. The diagnosis of NERD was confirmed by a 24-hour pH impedance test. RESULTS: The frequency of TLESRs did not differ between patients with NERD and controls. In patients with NERD, TLESRs were associated more often with reflux episodes than in controls (93% ± 6% vs 66% ± 19%; P < .05). Patients with NERD had a higher percentage of pure liquid reflux episodes (33% ± 15% vs 10% ± 2%; P < .05), whereas controls had a higher percentage of mixed reflux episodes (45% ± 16% vs 67% ± 17% in patients with NERD; P < .05). Patients with NERD also had a higher percentage of reflux (liquid and mixed) associated with common cavities (74% ± 18% vs 50% ± 20% in controls; P < .05). CONCLUSIONS: In contrast to previous studies, we found that TLESRs are associated more often with reflux in patients with NERD than control subjects; this association increases when only liquid and mixed refluxes are considered. These findings indicate that factors involved in the occurrence of reflux in patients with NERD during TLESRs are different from those in healthy subjects. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/23891920/Impedance_high_resolution_manometry_analysis_of_patients_with_nonerosive_reflux_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(13)01057-4 DB - PRIME DP - Unbound Medicine ER -