Esophageal manometry findings and degree of acid exposure in short and long Barrett's esophagus

Helman, Laura; Biccas, Beatriz; Lemme, Eponina; Novais, Paula; Fittipaldi, Viviane

doi:10.1590/s0004-28032012000100011

Cited by 6 publications

(1 citation statement)

References 19 publications

(53 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While patients with long-segment Barrett’s exhibited greater esophageal acid exposure than patients with short-segment Barrett’s, no difference was observed concerning esophageal contractile activity in a series of 46 Brazilian patients [60]. On the other hand, Loughney et al observed lesser esophageal peristaltic amplitude in patients with long-segment Barrett’s compared to controls [42]; a difference that was not observed in a comparison with short-segment Barrett’s patients.…”

Section: Esophageal Peristaltic Functionmentioning

confidence: 99%

Mechanisms of Barrett's oesophagus (clinical): LOS dysfunction, hiatal hernia, peristaltic defects

Roman

Kahrilas

2015

Best Practice & Research Clinical Gastroenterology

View full text Add to dashboard Cite

Summary Barrett’s esophagus, with the potential to develop into esophageal adenocarcinoma (EAC), is a major complication of gastroesophageal reflux disease (GERD). However, about 50% of patients developing EAC had no known GERD beforehand. Hence, while GERD symptoms, esophagitis, and Barrett’s have a number of common determinants (esophagogastric junction (EGJ) incompetence, impaired esophageal clearance mechanisms, hiatus hernia) they also have some independent determinants. Further, although excess esophageal acid exposure plays a major role in the genesis of long-segment Barrett’s esophagus there is minimal evidence supporting this for short-segment Barrett’s. Hence, these may have unique pathophysiological features as well. Long-segment Barrett’s seems to share most, if not all, of the risk factors for esophagitis, particularly high-grade esophagitis. However, it is uncertain if EGJ function and acid clearance are more severely impaired in patients with long-segment Barrett’s compared to patients with high-grade esophagitis. With respect to short-segment Barrett’s, the acid pocket may play an important pathogenic role. Conceptually, extension of the acid pocket into the distal esophagus, also known as intra-sphincteric reflux, provides a mechanism or acid exposure of the distal esophageal mucosa without the occurrence of discrete reflux events, which are more likely to prompt reflux symptoms and lead to the development of esophagitis. Hence, intra-sphincteric reflux related to extension of the acid/no acid interface at the proximal margin of the acid pocket may be key in the development of short segment Barrett’s. However, currently this is still somewhat speculative and further studies are required to confirm this.

show abstract

Section: Esophageal Peristaltic Functionmentioning

confidence: 99%