The effect of endogenous hypergastrinemia on lower esophageal sphincter pressure and esophageal motility.

ABSTRACT

BACKGROUND/AIMS: The effect of exogenous hypergastrinemia on esophageal motor function has been well documented. However, it is not known whether chronic endogenous hypergastrinemia influences esophageal motility and lower esophageal sphincter pressure. The purpose of this study was to investigate the effect of chronic hypergastrinemia on lower esophageal sphincter pressure and esophageal motility in patients with significantly elevated serum gastrin levels. METHODOLOGY: 37 patients (28 women; mean age, 53.7 years) with autoimmune gastritis and 35 functional dyspepsia patients participated in this study. Esophageal motility testing was performed by using an eight-lumen water-perfused catheter. Ten wet swallows were given and each contraction was analysed for lower esophageal sphincter pressure, lower esophageal sphincter relaxation, contraction amplitude and peak velocity. RESULTS: Mean serum fasting gastrin level was 1382.8±731.9pg/mL in patients with autoimmune gastritis and 107±83.9pg/mL in the control group (p=0.000). Mean lower esophageal sphincter pressure (31.6±14.42mmHg vs. 20.5±8.05mmHg, p=0.000) and mean contraction amplitude (82.48±35.0mmHg vs. 58.11±21.75mmHg, p=0.001), in hypergastrinemic patients were significantly higher than in the control group. CONCLUSIONS: These results suggest that in patients with autoimmune gastritis, prolonged and significant elevation of serum gastrin levels, increases lower esophageal sphincter pressure and esophageal body contraction amplitude. However, this increase in lower esophageal sphincter pressure does not cause upper gastrointestinal symptoms in patients with autoimmune gastritis.