The Spectrum of Motor Function Abnormalities in Gastroesophageal Reflux Disease and Barrett’s Esophagus

Ang, Daphne; Blondeau, Kathleen; Sifrim, Daniel; Tack, Jan

doi:10.1159/000210265

Cited by 34 publications

(36 citation statements)

References 212 publications

(151 reference statements)

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“…This fact coincides with the findings of Meneguetti et al (25) and Jorge et al (21) who also concluded that as the amount of mucosal damage increased from group without esophagitis to Barrett's esophagus, both esophageal motility and acid clearance worsened, suggesting that esophageal mucosal damage may contribute to esophageal dysmotility and worsening reflux (9) and that there is a direct relationship between the impairment of motor function and severity of esophageal reflux esophagitis (4,30) .…”

Section: Discussionsupporting

confidence: 87%

What Is the Real Impairment on Esophageal Motility in Patients With Gastroesophageal Reflux Disease?

Falcäo

Nasi

Brandão

et al. 2013

Arq. Gastroenterol.

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Context Impairment of esophageal motility is a common finding in patients with gastroesophageal reflux disease (GERD) as reduced lower esophageal sphincter (LES) basal pressure. A very low LES pressure might facilitate the occurrence of more gastroesophageal reflux whereas abnormal esophageal peristalsis may contribute to impaired esophageal clearance after reflux. Objective Evaluate the esophageal motor function of the lower esophageal sphincter and esophageal body in the various forms of gastroesophageal reflux disease. Methods The manometrics records of 268 patients, who had evaluation of the esophageal motility as part of the diagnostic gastroesophageal reflux disease were split into four groups, as follows: 33 patients who had no esophagitis; 92 patients who had erosive esophagitis; 101 patients who had short Barrett's esophagus and 42 patients who had long Barrett's esophagus. Results The group who had long Barrett's esophagus showed smaller mean LES pressure and higher percentage of marked LES hypotonia; in the distal segment of the esophageal body the this group showed higher percentage of marked hypocontractility of the distal segment (<30 mm Hg); this same group showed higher percentage of esophageal motility disorders. Conclusions The most intense esophageal motility disorders and lower pressure of lower esophageal sphincter were noted in the group with long Barrett's esophagus. Those with reflux esophagitis and short Barrett's esophagus had esophageal motility impairment, intermediate among patients with esophagitis and long Barrett's esophagus. Patients with typical symptoms of gastroesophageal reflux but without esophagitis by endoscopy study showed no impairment of esophageal motility.

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Section: Discussionsupporting

confidence: 87%

What Is the Real Impairment on Esophageal Motility in Patients With Gastroesophageal Reflux Disease?

Falcäo

Nasi

Brandão

et al. 2013

Arq. Gastroenterol.

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“…48 The aetiology of Barrett's mucosa, which represents the severest end of the reflux spectrum, is in turn a consequence of altered gastrointestinal anatomy and physiological mechanisms 49 the most significant of which are the alteration in intestinal motility 50 Gallbladder volume decreased gradually after the standard meal in all groups. The gallbladder volume decrease was slower in the Barrett's group and the cancer group and continued up to 60 min with no recovery toxicity of the resultant refluxate.…”

Section: Discussionmentioning

confidence: 99%

Does Impaired Gallbladder Function Contribute to the Development of Barrett’s Esophagus and Esophageal Adenocarcinoma?

Nassr

Gilani

Atie

et al. 2011

Journal of Gastrointestinal Surgery

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“…Since then this hypothesis has been widely accepted and recently most authors have agreed that the combined acidic and biliary reflux is one of the most important pathophysiological factors of the disease [23,31,32]. In contrast, so far only small series of patients have been examined to test this hypothesis [11,26,33].…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of Oesophageal Function in Patients with Different Types of Oesophageal Metaplasia

et al. 2011

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Aim: To evaluate the oesophageal function in patients with different types of oesophageal metaplasia and in cases with dysplasia on the basis of the Montreal definition of gastro-oesophageal reflux disease. Patients and Methods: 270 consecutive patients [M/F 151/119, mean age 54.2 years (19–84)] with endoscopic and histological evidence of oesophageal metaplasia were prospectively studied: patients with specialized intestinal metaplasia (SIM, n = 109) and patients without SIM (n = 161). Patients with SIM were subdivided into a dysplasia-positive (n = 34) and a dysplasia-negative (n = 75) group. All patients underwent reflux symptom analysis, oesophageal manometry, and simultaneous 24-hour pH and biliary reflux monitoring. Results: Patients with SIM were significantly older and had a significantly higher body mass index than patients without SIM. A significant male predominance was observed in patients with SIM and dysplasia compared to the dysplasia-negative group. The clinical symptom spectrum and the prevalence of erosive oesophageal lesions were similar in all groups. Patients with SIM had longer metaplastic segments, which was further increased in the dysplasia-positive group. During oesophageal manometry, pH and biliary reflux monitoring, patients with SIM had more severe alterations than patients without SIM, and these were further increased in patients with SIM and dysplasia. Conclusions: Patients with SIM had more severe oesophageal function abnormalities than those with other types of oesophageal metaplasia (e.g. gastric). The oesophageal function was further impaired if dysplasia was present in the metaplastic mucosa.

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The Spectrum of Motor Function Abnormalities in Gastroesophageal Reflux Disease and Barrett’s Esophagus

Cited by 34 publications

References 212 publications

What Is the Real Impairment on Esophageal Motility in Patients With Gastroesophageal Reflux Disease?

What Is the Real Impairment on Esophageal Motility in Patients With Gastroesophageal Reflux Disease?

Does Impaired Gallbladder Function Contribute to the Development of Barrett’s Esophagus and Esophageal Adenocarcinoma?

The Evaluation of Oesophageal Function in Patients with Different Types of Oesophageal Metaplasia

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