Esophageal Dynamics And Reflux Characteristics Of Gastroesophageal Reflux Disease Complicated With Laryngopharyngeal Reflux Disease

Objective: To study the characteristics of gastroesophageal reflux and esophageal dynamics in patients with gastroesophageal reflux disease complicated with laryngopharyngeal reflux disease through high resolution manometry and dynamic24-hour esophageal impedance pH monitoring.Methods: According to the strict inclusion and exclusion criteria,the outpatient or hospitalized patients who underwent high resolution esophageal manometry(HRM)and 24-hour esophageal impedance pH monitoring from People's Hospital of Xinjiang Uygur Autonomous Region between June2016 and December 2018 were chosen.The research groups include 105 cases of gastroesophageal reflux disease(GERD),or 35 cases of combined with laryngopharyngeal reflux disease(LPRD),and 70 cases of healthy controls from outpatient clinic without diagnosing with GERD and/or LPRD.,The data from HRM and esophageal 24 h pH monitoring were analyzed.Results: The proportions of males and females in the three groups were basically the same,and the results showed no significant difference between the groups(all P>0.05).The BMI of each group was compared.The results showed that the differences between the groups were statistically significant.Compared to healthy control group,BMI of other two groups was statistically significant(all P<0.05).In standing position,GERD+LPRD,GERD and healthy control group,the number of non-acid reflux was statistically significant(all P<0.05).There were no significant differences in the reflux,weak acid reflux,and exposure time(LES % above 5.0 cm)among all three groups(all P>0.05).The number of non-acid reflux was statistically significant among three groups(all P<0.05).In lying position,there were no significant differences in acid reflux,weak acid reflux,and exposure time among threegropus(LES % above 5.0 cm)(all P>0.05).The DeMeester score and the number of acid reflux were statistically significant among the three groups(all P<0.05).There were no significant differences in the indexes of acid reflux,weak acid reflux,and exposure time(LES % above 5.0 cm)among three groups(all P>0.05).Esophageal motility parameters,such as upper esophageal sphincter pressure,distal contraction score,distal contraction delay,and lower esophageal sphincter pressure in GERD+LPRD group,GERD group and healthy control group were statistically significant(all P<0.05);The parameters such as LES length.(cm),esophageal length(cm),esophageal length(cm),UES relaxation to the lowest pressure point(ms),UES relaxation duration(ms),UES recovery time(ms),and dry group internal pressure(mmHg)have no significant difference(all P>0.05).Conclusion: Compared to gastroesophageal reflux disease with typical symptoms,GERD+LPRD group in lying or standing position has significantly increased non acid reflux,distal integral,delayed distal contraction,and significantly decreased upper esophageal sphincter and lower esophageal sphincter pressure.These are also the characteristics of esophageal acid reflux and the abnormal esophageal dynamics in patients with gastroesophageal reflux disease combined with laryngopharyngeal reflux disease.