Study On Esophageal Motility In Patients With Functional Dyspepsia

Objective: To investigate the esophageal motility changes in patients with functional dyspepsia (FD).Methods: Esophageal manometry was performed in 30 patients with functional dyspepsia and in 15 healthy volunteers. Lower esophageal sphincter length (LESL),lower esophageal sphincter pressure (LESP),lower esophageal sphincter relaxation rate (LESRR) and peristalsis of esophageal body (including amplitude and types of peristalsis) were determined. At the same time, we assessed the Helicobacter pylori (Hp) infection rate in 30 FD patients with 14C- Urea Breath Test and Rapid Urease Test through gastro- scopy. In the two methods, the patients who were all positive or negative were identified with or without Hp infection.Results:⑴The test results of LESL,LESP,LESRR in the FD group: In FD patients and healthy volunteers, there were no significant differences in LESL(3.83±0.59cm vs 3.80±0.65cm),LESP(19.27±6.53mmHg vs 19.46±5.65mmHg),LESRR(91.26±11.16% vs 90.86±8.55%) (P>0.05).⑵The test results of contraction of esophageal body in the FD group: The average peristalsis amplitude of contraction of lower segment of eso- phageal body in FD patients was significantly lower than that in control group (58.07±24.06mmHg vs 113.98±30.28mmHg,P<0.001). The occur- ence rate that lower esophageal peristalsis pressure of FD group was lower than the upper of the same group was significantly higher than in the control group (11/30 vs 0/15, P<0.001). But between the FD patients and the healthy volunteers, there were no significant differences in the average peristalsis amplitude of contraction of upper segment of esophageal body (43.30±16.83mmHg vs 51.23±14.13mmHg, P>0.05).⑶The types of abnormal peristalsis waves in FD patients: The abnormal peristalsis waves in FD take up 16, as displayed as double-peak, three-peak, retropulsion and spontaneous contraction waves, etc. in different types and times, of which double-peak were mostly found. In 5 cases, two and more abnormal waves were found, with 8 cases having lower esophageal small amplitude. The incidence rate of esophageal motility abnormalitis is 63.33%.⑷The test results of Hp in FD patients: In FD patients, the prevalence of Helicobacter pylori (Hp) infection was 60%. In 15 Hp- positive patients versus 10 Hp-negative patients, there were no significant differences in LESL (3.90±0.57cm vs 3.85±0.63cm),LESP (20.31±7.64mm Hg vs 17.53±5.13mmHg),LESRR (89.65±14.35% vs 91.28±7.31%) and the average peristalsis amplitude of contraction of upper segment of esophageal body (40.58±16.88mmHg vs 45.94±18.66mmHg), as well as the average peristalsis amplitude of contraction of lower segment of esophageal body (53.34±24.89mmHg vs 62.86±21.80mmHg) (P>0.05).Conclusion: The abnormal esophageal motility could occur in patients with FD and could display in various types, which is characterised mostly by disorder of esophageal body movement (abnormal peristalsis waves) and secondly by decrease of lower esophageal movement. Although the H. pylori infection has no significant effects in the esophageal motility, the eradication therapy for patients with H. pylori positive functional dyspepsia is necessary. Our results indicate that, in clinical, patients with functional dyspepsia could take gastrointestinal motility drugs and be carried out H. pylori eradication therapy in order to improve their symptoms.