Analysis of Esophageal Motility in Patients with Nonerosive Reflux Disease

Background:Esophageal motility disorder plays an important role in the pathogenesis of gastroesophageal reflux disease(GERD).Aims:To investigate the characteristics of esophageal motility in different nonerosive reflux disease (NERD) subgroups.Methods:One hundred and sixty-one patients with typical gastroesophageal reflux symptoms and twenty healthy subjects were enrolled.Each individual was evaluated with upper gastrointestinal endoscopy,24-hour esophageal pH monitoring and esophageal manometry.NERD was diagnosed when the individual did not have either Barrett's esophagus or definite esophageal mucosal breaks at endoscopy and with a symptom index≥50%.According to the presence or absence of pathological acid reflux,patients with NERD were divided into abnormal acid reflux group and hypersensitive esophagus group.Manometric findings were compared between reflux group(n=28),hypersensitivity group (n=13) and control group(n=15).Results:Compared with control group,length of lower esophageal sphincter(LES) was shorter and LES pressure was lower in reflux group(P0.05),but there were no significant differences between hypersensitivity group and control group.Motility disorders in esophageal body mainly appeared in distal esophagus in both NERD subgroups and were manifested as lowering of distal esophageal contraction amplitude,slowing of peristalsis transmission velocity,and increasing of non-transmitted contractions,these disorders were more prominent in reflux group than in hypersensitivity group.Conclusions:Different esophageal motility characteristics are found in different NERD subgroups.Reduced LES length and pressure and more prominent distal esophageal motility disorders are seen in abnormal acid reflux subgroup of NERD.