Correlation between pathological distal esophageal acid exposure and ineffective esophageal motility.

Abstract

AIM: To assess the correlation between esophageal dysmotility, characterized as inefficient esophageal motility (IEM), and the presence of pathological acid reflux due to a structurally defective lower esophageal sphincter (LES), hiatus hernia. (HH), or esophagitis in patients with suspected gastroesophageal reflux disease (GERD). METHODS: 311 patients referred for GERD diagnostic procedures in a gastroesopahgeal motility laboratory were included in the study. Patients underwent an interview regarding their clinical symptoms, upper endoscopy (UE), stationary esophageal manometry, and 24-h esophageal pH-metry. The following risk factors of patients in the negative pH-metry group were compared to those in the positive pH-metry group: IEM, defective LES, HH, and esophagitis. The association between IEM and positive pH-metry results was first assessed by means of univariate analysis and later determined with multivariate logistic regression analysis. RESULTS: Out of the total of 311 studied patients, 208 met the inclusion criteria; 88 had normal and 120 had positive pH-metry results. Univariate analysis revealed that the occurrence of IEM, defective LES, and HH was significantly greater in the positive pH-metry group. Following logistic regression analysis, the occurrence of IEM remained significantly greater in the positive pH-metry group. CONCLUSIONS: IEM is associated with the presence of abnormal acid reflux, as assessed by 24-h esophageal pH-metry, regardless of the presence of defective LES, HH, or esophagitis.