Document Detail

Correlation of esophageal pH and motor abnormalities with endoscopic severity of reflux esophagitis.
MedLine Citation:
PMID:  15209742     Owner:  NLM     Status:  MEDLINE    
Motility abnormalities, common in gastroesophageal reflux disease, are likely to be related to endoscopic esophagitis. We studied pH and manometry parameters in relation to the severity of esophagitis. Forty-seven patients with symptomatic gastroesophageal reflux disease for > 3 months were evaluated by: (i) endoscopy (grading of esophagitis by Savary-Miller classification); (ii) mucosal biopsy; (iii) manometry; and (iv) 24-h pH-metry. We found Savary-Miller's grades of: 0 (9 patients out of 47), I (16/47), II (16/47), III (4/47), IV (2/47). Distal esophageal contraction amplitude was lower in severe (grade II to IV) as compared with mild (grade 0 and I) esophagitis (49 [7-182] versus 83 [27-196] mmHg [P = 0.001]). The length and pressure in the lower esophageal sphincter (LES), duration and velocity of contraction in the body, number of episodes of reflux and long-duration reflux, longest reflux, median pH, per cent of time with pH < 4 and DeMeester scores were not significantly different between the two groups. The area under pH 4 showed a negative correlation with LES pressure and amplitude of distal esophageal contractions. We conclude that higher endoscopic grades of esophagitis are associated with lower amplitude of contraction in distal esophagus. Lower LES pressure and distal esophageal contraction amplitude are associated with greater area under curve for pH below 4.
S K Somani; U C Ghoshal; V A Saraswat; R Aggarwal; A Misra; N Krishnani; S R Naik
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E     Volume:  17     ISSN:  1120-8694     ISO Abbreviation:  Dis. Esophagus     Publication Date:  2004  
Date Detail:
Created Date:  2004-06-22     Completed Date:  2004-09-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8809160     Medline TA:  Dis Esophagus     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  58-62     Citation Subset:  IM    
Copyright Information:
Copyright 2004 ISDE
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
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MeSH Terms
Endoscopy, Gastrointestinal / methods
Esophageal Motility Disorders / diagnosis*
Esophagitis, Peptic / diagnosis*
Esophagoscopy / methods*
Gastric Acidity Determination
Hydrogen-Ion Concentration*
Middle Aged
Monitoring, Physiologic
Sensitivity and Specificity
Severity of Illness Index
Statistics, Nonparametric

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