Potential of 24-hour manometry in diagnostics of motor disorders of the esophagus in patients with gastroesophageal reflux disease
Abstract
Aim of investigation. Studying of motor function of the esophagus by out-patient 24-hours manometry at healthy people and patients with various forms of gastroesophageal reflux disease (GERD).
Material and methods. Overall 53 patients (24 men, 29 women) with established diagnosis of GERD were enrolled to original study. Esophagogastroduod enoscopy was used for diagnostics of erosive form of GERD with assessment of stage of esophagitis, nonerosive form of GERD (NERD) was diagnosed by concurrent 24-hour pH-metry with 24-hour manometry. The control group included 10 healthy subjects (5 men, 5 women). 24-hour out-patient monitoring of esophageal motility has been carried out by 7-Fr-catheter, with three diminutive electron pressure sensors. Out-patient 24- hour esophageal pH-metry was carried out with application of catheter, having antimony electrode. Data on motility and pH changes were registered by the chart recorder. After 24-hour period all data were downloaded to personal computer for statistical processing.
Results. During investigation various disorders of motor activity of the esophagus in patients with GERD which have occurred during 24-hour monitoring were revealed. Disorders of motility of the esophagus, including disorders of voltage, duration of contractions and changes of structure of peaks of contractions that causes development of peristaltic dysfunction have been found. Increase of time of acid exposure of mucosa of the esophagus as consequence of ineffective motor function which does not provide clearance of lumen of the esophagus from refluxate was is revealed.
Conclusions. Obtained data allow to consider disorders of motility of the esophagus in combination to other factors as one of mechanisms in pathogenesis of GERD. Ineffective peristalsis results in increase of time of exposure of aggressive contents of the stomach to esophageal mucosa, promoting damage and development of specific symptoms.
About the Authors
D. V. PasechnikovRussian Federation
S. A. Bulgakov
Russian Federation
V. D. Pasechnikov
Russian Federation
References
1. Bremner R.M., Costantini M., DeMeester T.R. et al. Normal esophageal body function: A study using ambulatory esophageal manometry // Am. J. Gastroenterol. – 1998. – Vol. 93. – P. 183–187.
2. Chrysos E., Athanasakis E., Zoras O.J. et al. Twenty-four-hour ambulatory versus stationary esophageal manometry in the evaluation of esophageal motility in patients with gastroesophageal reflux disease // Digestion. – 2002. – Vol. 66. – P. 1–8.
3. Demeter P., Pap A. The relationship between gastroesophageal reflux disease and obstructive sleep apnea // J. Gastroenterol. – 2004. – Vol. 39. – P. 815–820.
4. Fouad Y.M., Katz P.O., Hatlebakk J.G., Cas-tell D.O. Ineffective esophageal motility: The most common motility abnormality in patients with GERD-associated respiratory symptoms // Am. J. Gastroenterol. – 1999. – Vol. 94. – P. 1464–1467.
5. Holloway R.H. Esophageal body motor response to reflux events: secondary peristalsis // Am. J. Med. – 2000. – Vol. 108. – P. 20–26.
6. Jeffery H.E., Ius D., Page M. The role of swallowing during active sleep in the clearance of reflux in term and preterm infants // J. Pediatr. – 2000. – Vol. 137. – P. 545–548.
7. Johnson L.F., DeMeester T.R. Development of the twenty-four-hour intraesophageal pH monitoring composite scoring system // J. Clin. Gastroenterol. – 1986. – Vol. 8. – P. 52–58.
8. Kahrilas P.J., Dodds W.J., Hogan W.J. Effect of peristaltic dysfunction on esophageal volume clearance // Gastroenterology. – 1988. – Vol. 94. – P. 73–80.
9. Kasapidis P., Xynos E., Mantides A. et al. Differences in manometry and 24-hour ambulatory pH-metry between patients with and without endoscopic or histological esophagitis. //Am. J. Gastroenterol. – 1993. – Vol. 88. – P. 198–202.
10. Leite L.P., Jonhnston B.T., Barrett J. et al. Ineffective esophageal motility (IEM): The primary finding in patients with nonspecific esophageal motor disorder // Dig. Dis. Sci. – 1997. – Vol. 42. – P. 1859–1865.
11. Lundell L.R., Dent J., Bennett J.R. et al. Endoscopic assessment of esophagitis: clinical and functional correlates and further validation of the Los Angeles classification // Gut. – 1999. – Vol. 45. – P. 172–180.
12. Stein H.J., DeMeester T.R. Indications, technique and clinical use of ambulatory 24-hour esophageal motility monitoring in a surgical practice // Ann. Surg. – 1993. – Vol. 217. – P. 128–137.
Review
For citations:
Pasechnikov D.V., Bulgakov S.A., Pasechnikov V.D. Potential of 24-hour manometry in diagnostics of motor disorders of the esophagus in patients with gastroesophageal reflux disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(5):34-38. (In Russ.)
Views:
10
Email this article 
