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[The relationship between acid reflux and esophageal motility, esophagitis and cardiac morphology in gastroesophageal reflux disease].
Zhonghua Yi Xue Za Zhi. 2019 Nov 26; 99(44):3494-3499.ZY

Abstract

Objective:

To analyze the relationship between the severity of esophageal acid reflux and esophageal motility, esophageal mucosal injury and morphological anatomy of gastroesophageal junction (GEJ) in patients with gastroesophageal reflux disease (GERD).

Methods:

The clinicaldata of GERD patients who underwent 24 h pH-impedance monitoring, gastroscopy and high-resolution manometry (HRM) from January 2016 to January 2019 in the Gastroesophageal Surgery Department of PLA Rocket Force Characteristic Medical Center were retrospectively analyzed. The patients were divided into non-pathological acid reflux group, mild pathological acid reflux group and moderate to severe pathological acid reflux group according to the DeMeester score. The gender and age of each group were matched, with 60 cases in each group. Statistical analysiswas performed to analyze thedifferences in upper esophageal sphincter pressure, lower esophageal sphincter pressure (LES), LES length, length of ventral LES, percentage of ineffective swallowing, esophagitis, Hill grade of GEJ, and hiatus hernia (HH) in each group. The comparison and correlation analysis are also carried out between the groups.

Results:

The male-female ratio was 33/27, and the age was (57±13) years in each group. Non-parametric analysis showed that the LES pressure and the length of the ventral LES decreased with the severity of acid reflux, and there was a statistical difference (P= 0.033, P=0.015). The detection rate of HH by HRM increased significantly (χ(2)=0.001) as well. Esophagitis score increased with the severity of acid reflux and there was statistical difference (P<0.001).The detection rate of esophagitis increased significantly (χ(2)<0.001) as well. Hill grading score of GEJ increased with the severity of acid reflux, and there was statistical difference (P<0.001).The detection rate of HH by endoscopy increased significantly (χ(2)<0.001) as well. The correlation between DeMeester score and LES pressure, length of ventral LES, percentage of ineffective swallowing, esophagitis score, and Hill grade score were statistically significant (P<0.05).

Conclusions:

The esophageal low motility (such as low LES pressure) and anatomical abnormalities (abdominal esophageal shortening, GEJ flabbiness, and even HH formation) of the GEJ regionare significantly associated with the severity of acid reflux. These factors may be important causes of increased acid reflux. In addition, the aggravation of acid reflux can also increase the incidence and severity of esophagitis.

Authors+Show Affiliations

Gastroesophageal Surgery Department, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China.No affiliation info availableNo 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)

Journal Article

Language

chi

PubMed ID

31826568

Citation

Hu, Z W., et al. "[The Relationship Between Acid Reflux and Esophageal Motility, Esophagitis and Cardiac Morphology in Gastroesophageal Reflux Disease]." Zhonghua Yi Xue Za Zhi, vol. 99, no. 44, 2019, pp. 3494-3499.
Hu ZW, Xu H, Zhan Y, et al. [The relationship between acid reflux and esophageal motility, esophagitis and cardiac morphology in gastroesophageal reflux disease]. Zhonghua Yi Xue Za Zhi. 2019;99(44):3494-3499.
Hu, Z. W., Xu, H., Zhan, Y., Xin, R. H., Sun, C. Y., Tian, S. R., Zhan, X. L., Chen, D., Wang, Z. G., & Wu, J. M. (2019). [The relationship between acid reflux and esophageal motility, esophagitis and cardiac morphology in gastroesophageal reflux disease]. Zhonghua Yi Xue Za Zhi, 99(44), 3494-3499. https://doi.org/10.3760/cma.j.issn.0376-2491.2019.44.009
Hu ZW, et al. [The Relationship Between Acid Reflux and Esophageal Motility, Esophagitis and Cardiac Morphology in Gastroesophageal Reflux Disease]. Zhonghua Yi Xue Za Zhi. 2019 Nov 26;99(44):3494-3499. PubMed PMID: 31826568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The relationship between acid reflux and esophageal motility, esophagitis and cardiac morphology in gastroesophageal reflux disease]. AU - Hu,Z W, AU - Xu,H, AU - Zhan,Y, AU - Xin,R H, AU - Sun,C Y, AU - Tian,S R, AU - Zhan,X L, AU - Chen,D, AU - Wang,Z G, AU - Wu,J M, PY - 2019/12/13/entrez PY - 2019/12/13/pubmed PY - 2019/12/18/medline KW - Esophageal pH monitoring KW - Esophagitis KW - Gastroesophageal reflux KW - Gastroscopy KW - Hiatal hernia KW - Manometry SP - 3494 EP - 3499 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 99 IS - 44 N2 - Objective: To analyze the relationship between the severity of esophageal acid reflux and esophageal motility, esophageal mucosal injury and morphological anatomy of gastroesophageal junction (GEJ) in patients with gastroesophageal reflux disease (GERD). Methods: The clinicaldata of GERD patients who underwent 24 h pH-impedance monitoring, gastroscopy and high-resolution manometry (HRM) from January 2016 to January 2019 in the Gastroesophageal Surgery Department of PLA Rocket Force Characteristic Medical Center were retrospectively analyzed. The patients were divided into non-pathological acid reflux group, mild pathological acid reflux group and moderate to severe pathological acid reflux group according to the DeMeester score. The gender and age of each group were matched, with 60 cases in each group. Statistical analysiswas performed to analyze thedifferences in upper esophageal sphincter pressure, lower esophageal sphincter pressure (LES), LES length, length of ventral LES, percentage of ineffective swallowing, esophagitis, Hill grade of GEJ, and hiatus hernia (HH) in each group. The comparison and correlation analysis are also carried out between the groups. Results: The male-female ratio was 33/27, and the age was (57±13) years in each group. Non-parametric analysis showed that the LES pressure and the length of the ventral LES decreased with the severity of acid reflux, and there was a statistical difference (P= 0.033, P=0.015). The detection rate of HH by HRM increased significantly (χ(2)=0.001) as well. Esophagitis score increased with the severity of acid reflux and there was statistical difference (P<0.001).The detection rate of esophagitis increased significantly (χ(2)<0.001) as well. Hill grading score of GEJ increased with the severity of acid reflux, and there was statistical difference (P<0.001).The detection rate of HH by endoscopy increased significantly (χ(2)<0.001) as well. The correlation between DeMeester score and LES pressure, length of ventral LES, percentage of ineffective swallowing, esophagitis score, and Hill grade score were statistically significant (P<0.05). Conclusions: The esophageal low motility (such as low LES pressure) and anatomical abnormalities (abdominal esophageal shortening, GEJ flabbiness, and even HH formation) of the GEJ regionare significantly associated with the severity of acid reflux. These factors may be important causes of increased acid reflux. In addition, the aggravation of acid reflux can also increase the incidence and severity of esophagitis. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/31826568/[The_relationship_between_acid_reflux_and_esophageal_motility_esophagitis_and_cardiac_morphology_in_gastroesophageal_reflux_disease]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0376-2491&amp;year=2019&amp;vol=99&amp;issue=44&amp;fpage=3494 DB - PRIME DP - Unbound Medicine ER -