The Correlation Between Upper And Lower Esophageal Sphincter Thickness And Pressure In Patients With Gastroesophageal Reflux Disease

Objective:Gastroesophageal reflux disease(GERD)is a common disease in gastroenterology.Structural and functional abnormalities of Upper Esophageal Sphincter(UES)and Lower Esophageal Sphincter(LES)are known to be one of the important pathogenesis of GERD.In this study,high-resolution esophageal manometry combined with electronic ultrasonic gastroscopy were used to measure the pressure and the thickness of UES and LES to explore the relationship between the pressure and the thickness of UES and LES,providing basis for further research on the pathogenesis of GERD.Method:To collect patients hospitalized in the Department of gastroenterology or patients from outpatient department of the 967 Hospital of the Chinese People’s Liberation Army Joint Logistic Support Force from November 2021 to November 2022.According to the results of gastroscopy,the patients were divided into reflux esophagitis(RE)group and non-erosive reflux disease(NERD)group,including 21 and 29 patients,respectively.A total of 20 patients with no typical GERD symptoms such as acid reflux and heartburn,no other gastrointestinal diseases or gastrointestinal surgery history or organic diseases were selected as the control group.The OLYMPUSUM-3R ultrasonic gastroscope device was used to measure the thickness of UES and LES,and the resting pressure of UES and LES was measured by GAP-36A.The resting pressure and the thickness of UES and LES were compared among the three groups,and the relationship between the thickness and pressure of UES and LES was analyzed.SPSS26.0 software was used for statistical analysis,and P<0.05 was considered statistically significant.Result:1.General information:A total of 70 patients were enrolled in this study,including 21patients in the RE group,of which there were 9 males(42.86%)and 12 females(57.14%),with an average age of 52±11years,an average course of disease of 5.00±0.55 years,and an average BMI of 25.06±0.31 kg/m~2.The NERD group included 29 patients,including 15males(51.72%)and 14 females(48.28%).The mean age was 49±10 years,the mean course of disease was 4.07±0.59 years,and the mean BMI was 23.64±0.28 kg/m~2.The control group included 20 patients,including 12 males(60.00%)and 8 females(40.00%),with an average age of 51±10 years,an average course of disease of 3.75±0.55 years,and an average BMI of 23.49±0.27 kg/m~2.There was no significant difference in age,course of disease or gender among the three groups(P>0.05).Comparing the BMI of the three groups,the results showed that the BMI of the RE group was higher than that of the NERD group and the control group,with statistical significance(P<0.05),while the BMI of the NERD group was not statistically significant compared with the control group(P>0.05).2.The UES resting pressure of RE group and NERD group was lower than that of control group,and the difference was statistically significant(P<0.05).The UES resting pressure in RE group was lower than that of NERD group,and the difference was statistically significant(P<0.05).3.The LES resting pressure of RE group and NERD group was lower than that in control group,and the difference was statistically significant(P<0.05).LES resting pressure in RE group was lower than that in NERD group,and the difference was statistically significant(P<0.05).4.The thickness of UES and LES in RE and NERD group was smaller than that in control group,and the difference was statistically significant(P<0.05).The thickness of UES and LES in RE group was smaller than that in NERD group,and the difference was statistically significant(P<0.05).5.Pearson correlation analysis showed that UES and LES thickness were positively correlated with resting pressure(r>0 and P<0.05).Conclusion:1.Patients with gastroesophageal reflux disease have decreased resting pressure of UES and LES,and the lower the resting pressure of UES and LES,the more severe the degree of esophageal mucosal damage may be.2.The thickness of UES and LES is positively correlated with the resting pressure.The larger the thickness of UES and LES,the higher the resting pressure.3.UES and LES play an important role in the pathogenesis of GERD,and theapplication of electronic ultrasound gastroscopy combined with gastrointestinal motility detection system can effectively evaluate the structure and function of UES and LES.