Characteristics Of Esophageal Motility And Acid Exposure In Patients With Gastroesophageal Reflux Disease

Objective: By analyzing the results of high resolution esophageal manometry and 24 h esophageal p H-impedance monitoring in patients with different types of gastroesophageal reflux disease(GERD),the characteristics of esophageal motility and acid exposure were investigated.Methods: The study participants were selected from the Department of Gastroenterology out-patient and in-patient Department of the first affiliated Hospital of Medical College of Shihezi University from July 2017 to July 2018.Gastroscopy,high resolution esophageal manometry and 24 h esophageal p H-impedance monitoring were performed.A total of 59 patients with gastroesophageal reflux disease were selected according to the diagnostic criteria,inclusion criteria and exclusion criteria..The patients were divided into a reflux esophagitis(RE)group(27 cases,male/female: 12/15)and a nonerosive reflux disease(NERD)group(32 cases,male/female: 14/18)according to whether the gastroscope has esophageal mucosa erosion or ulceration.The results of high-resolution esophageal manometry and 24-hour esophageal p H-impedance monitoring was compared between the two groups.Results: 1.The results of high resolution esophageal manometry: the resting pressure of lower esophageal sphincter in RE group was significantly lower than that in NERD group,the difference was statistically significant(P < 0.05).There was no significant difference between the two groups in residual pressure of upper and lower esophageal sphincter and rest pressure of upper esophageal sphincter.(P > 0.05).The amplitude of distal wave in RE group was lower than that in NERD group,the difference was statistically significant(P < 0.05).There was no significant difference between the two groups in peristaltic wave duration,initial velocity and distal contraction delay time(P > 0.05).2.Monitoring results of 24 h esophageal p H-Impedance:The score of De Meester in RE group was significantly higher than that in NERD group,the difference was statistically significant(P < 0.05),and the total acid reflux time was lower than that in NERD group,the difference was statistically significant(P < 0.05).There was no significant difference in total reflux times,standing position reflux times and different physical properties(P > 0.05).Conclusion: There were differences in esophageal motility and acid exposure among different types of GERD patients.The rest pressure of lower esophageal sphincter and the amplitude of distal wave in RE patients were lower than those in NERD patients,and the De Meester score was higher than that in NERD patients.