SUMMARY Oesophageal manometry and 24 hour ambulatory pH recordings from the distal oesophagus were carried out in 25 patients with complications of oesophagitis (stricture, Barrett's oesophagus or oesophageal ulcer) and compared with 25 patients with uncomplicated oesophagitis. Acid reflux was more severe in the complicated group with 26-2% of time below pH 4 compared with 11-3% in uncomplicated patients (p<0.0l). This difference was most marked at night, when complicated patients had long periods of acici reflux with 35/6% time less than pH 4 compared with 5-2% uncomplicated (p<0-))1). The mean duration of nocturnal acid reflux was 15-4 minutes (2-1 minutes uncomplicated, p<0.001). Oesophageal motility was markedly abnormal in all groups, but with no demonstrable differences in lower oesophageal sphincter pressure or peristalsis between the groups. Patients with complications of oesophagitis have different patterns of acid reflux from uncomplicated patients, with prolonged nocturnal bathing of the oesophageal mucosa, which may be the cause of stricture formation, metaplasia, or ulceration.

No abstract

No abstract

No abstract

SUMMARY Ambulatory oesophageal pH, oesophageal manometry and fasting serum gastrin concentrations were carried out on 28 patients with reflux oesophagitis, before and during treatment with ranitidine 300 mg bd. Fourteen patients healed endoscopically at six weeks (group A) and 14 had residual oesophagitis (group B). Group A were characterised by a lower serum gastrin concentration before treatment (4.52 pmol/l; 2-4-10: mean and range) than group B (11