Is all ineffective esophageal motility the same? A clinical and high-frequency intraluminal US study - 23/08/11
Reprint requests: Poong-Lyul Rhee, MD, Division of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, Korea 135-710.Seoul, Korea
Abstract |
Background |
Ineffective esophageal motility (IEM) is characterized by frequent hypotensive or failed peristaltic contractions; its pathophysiology is controversial.
Objective |
To evaluate whether patients with IEM because of GERD would differ from patients with other etiologies of IEM on the basis of esophageal-muscle thickness measured by high-frequency intraluminal US (HFIUS).
Design |
Single-center prospective study.
Setting |
Academic medical center; from January 2004 to June 2005.
Subjects |
A total of 46 patients who were newly diagnosed with IEM were classified into 2 groups: GERD-related IEM (group I, n = 26) and non-GERD–related IEM (group II, n = 20) on the basis of the presence of reflux esophagitis and/or pathologic acid exposure by 24-hour esophageal pH monitoring. In addition, 16 asymptomatic healthy volunteers with no reflux esophagitis, normal manometric finding, and normal level of acid exposure were included as controls.
Main Outcome Measurements |
We compared the clinical characteristics, including a predominant principal esophageal symptom and the results from HFIUS among the control, GERD-related IEM (group I), and non-GERD–related IEM (group II) groups.
Results |
The proportion of typical reflux symptom as a predominant symptom was higher in group I (66%) than in group II (25%). Muscle thickness was greater in group II than in group I and the control group during both the baseline rest period and the peak of contraction period at all levels of the middle of the lower esophageal sphincter (LES), and 3 cm and 9 cm above the LES (respectively) (P < .05).
Limitation |
The limitation was the small sample size.
Conclusions |
Patients with non-GERD–related IEM had increased muscle thickness on HFIUS compared with patients with GERD-related IEM and the controls. Based on this study, IEM is not necessarily indicative of GERD.
Le texte complet de cet article est disponible en PDF.Abbreviations : BMI, DES, HFIUS, IEM, LES, NCCP, VAS
Plan
Vol 68 - N° 3
P. 422-431 - septembre 2008 Retour au numéro
Article précédent
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