A Research About The Relation Between Esophageal Motility Dysfunction And The Classification Of Gastroesophageal Reflux Disease

Background and Objective:(Gastroesophageal reflux disease GERD) is stomach andduodenal contents reflux to the esophagus. pharyngeal. ear. nose and other parts.Accompanied by heartburn. acid reflux.chest pain. difficulty swallowing.bleeding.chesttightness. cough symptoms. Usually gastro esophageal reflux disease based on results ofendoscopy, esophageal damage can be divided into two types.(Non erosive reflux diseaseNERD)， Esophageal mucosa without obvious lesions that non-erosive gastro esophagealreflux disease (Non erosive reflux disease NERD), namely the so-called" disease reflux(Reflux esophagitis RE), Significant erosion, ulcers and other inflammatory lesions, calledreflux esophagitis (Reflux esophagitis RE), the so-called" pathological reflux. Clinicallyknown as gastro esophageal reflux disease to refer to NERD. Its causes may be related toobesity, diet, psychological, esophageal and gastric anti-reflux barrier damage, esophagealclearance dysfunction, gastro duodenal rectal dysfunction, such as gastric emptying andgastro duodenal reflux related.China’s GERD is common, but our large sample size on therelationship of GERD and esophageal motility dysfunction is still rarely. Olsen and Schlegelfirst reported gastro esophageal reflux disease and esophageal motility disorder, this studyaims to use advanced esophageal manometry (HRM) on the different categories of GERD,esophageal manometry, get esophageal sphincter (Lower LES) of esophageal sphincter length,pressure, esophageal peristaltic amplitude and contraction duration data to be analyzed. Findthe relationship between the different classification of gastro esophageal reflux disease andesophageal motility dysfunction, play a guiding role for the clinical treatment of refluxesophagitis.Materials and methods: From July2010to February2012due to heart burn, anti-acids, chest pain, pharyngeal foreign body sensation, sense of eating stems choke, cough, chest tightness and other symptoms to hospital and underwent endoscopy diagnosedaccording to the Los Angeles classification for reflux esophagitis spondylitis patients, toexclude peptic ulcer disease, systemic sclerosis, diabetes, connective tissue disease, history ofgastro esophageal surgery and esophageal manometry diaphragm pressure with position andLES pressure with a distance of more than2cm by. Endoscopic diagnosis of reflux esophagitisRE group, the endoscopic diagnosis without reflux esophagitis were divided into the NERDgroup, another recruit without reflux symptoms and gastroscopy with chronic superficialgastritis-Non-atrophic and no other complications were divided into control group. The U.S.ManoScan360°solid-state high-resolution esophageal manometry, esophageal manometry.8hours of fasting before the test, prohibit the taking of drugs affecting gastrointestinal motility24hours, non-smoking, wine, coffee12hours. Patient supine, insert the electrode to theappropriate location from the nostrils after taking the resting data,10patients watering. Theend of the inspection, fast out of the electrode to analyze the data. Evaluation of esophagealLES length, pressure, residual pressure, the LES on the edge of3,7,11cm volatility and Poveyhold time, the mean amplitude of the distal esophagus and Povey hold time, the contraction ofcutting-edge speed, and whether esophageal motility dysfunction. Using statistical analysis tofind the classification of reflux esophagitis in patients with esophageal peristalsis discrepancyResults: using the software SPSS17.0, the mean of the pairwise analysis of samples inthe analysis of variance method TUKEY Inspection Act, X~2test pairwise analysis of countdata, P<0.05for meaningful.(1) LES length: Most of the control group within the normal range of individual shorterbut close to normal; of NERD group and RE group are13cases lower than normal.(2) LES resting pressure: The control group, one exception the rest were within normalrange, there are five cases of NERD group lower than normal, and RE group had eight casesof lower than normal.(3) LES residual pressure, the CFV,11,7,3cm above the LES-wave duration, wave the average maintenance time: Three groups are within the normal range, and three groups ofroughly the same.(4) LES11,7,3cm in amplitude and average amplitude: Control group were within thenormal range, but the NERD group the individual is below normal, RE set of amplitude lowerthan normal number of significantly greater than the other two groups. And three groups werecompared in cases within the normal range of volatility can also see the RE group volatilitylower than the NERD group than the control group.(5) Dysfunction: Control group, eight cases of the NERD group accounted for28.6%ofRE group accounted for75%in24cases. RE group dysfunction ratio is much larger than theother two groups.(6) LES resting pressure in the control group and RE group,11,7cm in the LES on thevolatility of the RE group and the NERD group, the3cm volatility of the LES on the REgroup and the control group and the NERD group, the average volatility of the RE group andthe control group and the NERD group were statistically significant; Dysfunction in eachgroup was statistically significant. There was no statistically significant pair wise comparison.Conclusion: The different types of gastroesophageal reflux disease have specificity theabnormal esophageal pressure.