Influence of Positions on Esophageal Acid Reflux Patterns and Clinical Therapy

【Objective】To investigate the correlation of esophageal acid reflux patterns of different positions with endoscopic severity of gastroesophageal reflux disease(GERD).【Methods】Ninety-one cases of GERD were divided into two groups according to the endoscopic reflux esophagitis or pathological results of 24-hour esophageal pH monitoring:non-erosive reflux disease(NERD)(n=50) and erosive esophagitis(EE)(n=41).The esophageal pH parameters in the upright versus supine positions were compared between two groups and compared among patients with various severity grades of reflux esophagitis.【Results】The index values of supine acid reflux in NERD group such as number of reflux episodes,number of reflux episodes of more than 5 min duration,duration of longest reflux episode,percentage of time pH4 were 12.5(0~68),0(0~8),5(0~53),2(0~24.7),respectively,significantly lower than those of EE,27(0~246),1(0~11),10(0~102),5.4(0~72) respectively(P0.05),there were no differences in the index values of upright acid reflux between two groups studied.The supine values of number of reflux episodes and percentage of time pH4 in patients with grade C esophagitis(Los Angeles classification) were significantly higher than those in patients with grade A and grade B esophagitis.【Conclusion】Supine reflux is in relation to the development and severity of esophageal injury.