Motility abnormalities in esophageal body in GERD: are they truly related to reflux?

ABSTRACT

BACKGROUND: Esophageal motility abnormalities have been observed in patients with gastroesophageal reflux disease. GOALS The aim of the present study was to determine if esophageal motor disorders in patients with a positive response to the omeprazole test are related to the existence of reflux or they are concomitant findings. STUDY A 24-hour pH monitoring and a stationary manometry were performed on 128 patients 49 of them had normal manometry, 31 hypotensive lower esophageal sphincter, 29 motor disorder in esophageal body, and 19 hypotensive lower esophageal sphincter and motor disorder in esophageal body. RESULTS: We found an association between the presence of abnormal reflux and motor disorder in esophageal body (chi test; P < 0.05). However, ineffective esophageal motility was the disorder most strongly related to reflux, whereas the hypercontractile disorders were not clearly attributed to it. CONCLUSIONS: Esophageal manometric abnormalities should be considered cautiously before considering a motor disorder as a consequence of abnormal reflux.