Esophageal manometry in gastroesophageal reflux disease. Lower esophageal sphincter incompetence or esophageal dismotility?
Valdovinos Díaz, M.A.; Flores, C.; Facha, M.T.; Koller Lucio, J.
Revista de Gastroenterologia de Mexico 64(1): 16-18
1999
ISSN/ISBN: 0375-0906 PMID: 10532117 Document Number: 511812
Hipotensive lower esophageal sphincter (HLES) has been considered the most frequent finding in patients with gastroesophageal reflux disease (GERD). Recently it has been published that esophageal dismotility (ED) has a higher prevalence in GERD. To compare the prevalence of HLES with ED in patients with GERD. Consecutive patients with endoscopic esophagitis grade II or higher and abnormal esophageal acid exposure time in pH-monitoring were evaluated. Stationary esophageal manometry were performed in all patients. HLES was defined by: a) LES pressure < 10 mmHg, b) LES length < 2 cm and c) LES abdominal segment < 1 cm. ED was defined by: a) presence of more than 30% of peristaltic waves with an amplitude < 30 mmHg or b) more than 10% of simultaneous waves in distal esophagus. Thirty-seven patients, 27 women and 10 men were evaluated. Twelve patients (32.4%) had ED, 5 (13.5%) showed HLES. Four of these 17 patients had both abnormalities. Fifteen patients (40.5%) had normal findings and in 5 (13.5%) a high LES pressure was found. Esophageal dismotility is the most common manometric abnormality in patients with GERD.