Ambulatory esophageal pressure and pH monitoring in patients with high-grade reflux esophagitis

Timmer, Robin; Breumelhof, R.; Nadorp, J. H. S. M.; Smout, A. J. P. M.

doi:10.1007/bf02090354

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…Compared with healthy controls, significantly decreased esophageal contraction amplitudes after swallowing, increased frequency of failed peristaltic sequences, and hypotensive LES pressures have all been noted in individuals with the disease (12,31). Significantly decreased contraction durations and peristaltic propagation velocity in patients with severe reflux esophagitis have also been observed (31). It is important to note that such abnormalities appear to be related to the severity of the esophagitis in GERD patients (12).…”

Section: Discussionmentioning

confidence: 99%

“…Peristaltic dysfunction and LES hypotension are also commonly observed in patients with GERD. Compared with healthy controls, significantly decreased esophageal contraction amplitudes after swallowing, increased frequency of failed peristaltic sequences, and hypotensive LES pressures have all been noted in individuals with the disease (12,31). Significantly decreased contraction durations and peristaltic propagation velocity in patients with severe reflux esophagitis have also been observed (31).…”

Section: Discussionmentioning

confidence: 99%

“…Esophageal peristaltic dysfunction has also been implicated in the pathogenesis of GERD. In humans with reflux esophagitis, incomplete or failed peristalsis (12), decreased amplitudes (12,30,31) and durations (30,31) of peristaltic contractions in the smooth muscle esophagus, and decreased resting LES pressure (12,31) have all been observed. However, such disturbances of esophageal motility are most pronounced in patients with more severe cases of esophagitis (12,30) and are often not demonstrated in lower-grade cases (1,10,29,30).…”

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confidence: 99%

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Esophagitis-related esophageal shortening in opossum is associated with longitudinal muscle hyperresponsiveness

White¹,

Zhang²,

Morris³

et al. 2001

American Journal of Physiology-Gastrointestinal and Liver Physi

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Acute intraluminal acid perfusion induces esophageal shortening in humans and opossums. Lower esophageal sphincter (LES) hypotension and peristaltic dysfunction occur in patients and animal models of reflux esophagitis. This study examined whether similar shortening and motor dysfunction occur in anesthetized opossums after repeated esophageal acid exposure and whether this is associated with longitudinal muscle (LM) hyperresponsiveness. Manometry used before and after 3 consecutive days of 45-min perfusion with 100 mmol/l HCl or normal saline measured esophageal length and motor responses to induced swallows. LM electrical and mechanical responses were assessed using standard isometric tension and intracellular recording techniques. Compared with controls, repeated acid perfusion induced erosive esophagitis and significant esophageal shortening, associated with enhanced LM responses to carbachol, a significantly depolarized resting membrane potential, and abnormal spike patterns. LES resting pressure and swallow-induced peristalsis were unaffected. In this model of reflux esophagitis, marked persistent esophageal shortening and associated LM hyperresponsiveness occur before significant LES or peristaltic dysfunction, suggesting that esophageal shortening is the earliest motor disorder induced by acid injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Esophagitis-related esophageal shortening in opossum is associated with longitudinal muscle hyperresponsiveness

White¹,

Zhang²,

Morris³

et al. 2001

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…Impairment in oesophageal motility during GORD has been investigated only for relatively short periods of observations 16 , 17 . More recent 24‐h analyses demonstrated a trend toward an impairment of oesophageal peristalsis in GORD patients 18 . However, the lack of swallow monitoring did not allow a precise classification of oesophageal motor events.…”

Section: Discussionmentioning

confidence: 99%

Swallows, oesophageal and gastric motility in normal subjects and in patients with gastro‐oesophageal reflux disease: a 24‐h pH‐manometric study

Grossi

et al. 1998

Neurogastroenterology Motil

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“…Various motor-disorders have been detected in GERD including a significantly high rate of incomplete primary peristalsis, changes in esophageal motility and an increased number of non-transmitted contractions [6,19]. Contractions had a shorter duration and a slower propagation velocity [20]. …”

Section: Discussionmentioning

confidence: 99%

Electroesophagogram in gastroesophageal reflux disease with a new theory on the pathogenesis of its electric changes

et al. 2004

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BackgroundIn view of the disturbed esophageal peristaltic activity and abnormal esophageal motility in gastroesophageal reflux disease, (GERD), we investigated the hypothesis that these changes result from a disordered myoelectric activity of the esophagus.MethodsThe electric activity of the esophagus (electroesophagogram, EEG) was studied in 27 patients with GERD (16 men, 11 women, mean age 42.6 ± 5.2 years) and 10 healthy volunteers as controls (6 men, 4 women, mean age 41.4 ± 4.9 years). According to the Feussner scoring system, 7 patients had a mild (score 1), 10 a moderate (score 2) and 10 a severe (score 3) stage of the disease. One electrode was applied to the upper third and a second to the lower third of the esophagus, and the electric activity was recorded. The test was repeated after the upper electrode had been moved to the mid-esophagus.ResultsThe EEG of the healthy volunteers showed slow waves and exhibited the same frequency, amplitude and conduction velocity from the 2 electrodes of the individual subject, regardless of their location in the upper, middle or lower esophagus. Action potentials occurred randomly. In GERD patients, score 1 exhibited electric waves' variables similar to those of the healthy volunteers. In score 2, the waves recorded irregular rhythm and lower variables than the controls. Score 3 showed a "silent" EEG without waves.ConclusionThe electric activity in GERD exhibited 3 different patterns depending on the stages of GERD. Score 1 exhibited a normal EEG which apparently denotes normal esophageal motility. Score 2 recorded irregular electric waves variables which are presumably indicative of decreased esophageal motility and reflux clearance. In score 3, a "silent" EEG was recorded with probably no acid clearance. It is postulated that the interstitial cells of Cajal which are the electric activity generators, are involved in the inflammatory process of GERD. Destruction of these cells appears to occur in grades that are in accordance with GERD scores. The EEG seems to have the potential to act as an investigative tool in the diagnosis of GERD stages.

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Ambulatory esophageal pressure and pH monitoring in patients with high-grade reflux esophagitis

Cited by 9 publications

References 9 publications

Esophagitis-related esophageal shortening in opossum is associated with longitudinal muscle hyperresponsiveness

Esophagitis-related esophageal shortening in opossum is associated with longitudinal muscle hyperresponsiveness

Swallows, oesophageal and gastric motility in normal subjects and in patients with gastro‐oesophageal reflux disease: a 24‐h pH‐manometric study

Electroesophagogram in gastroesophageal reflux disease with a new theory on the pathogenesis of its electric changes

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