MOTILITY ABNORMALITIES IN THE COLUMNAR-LINED ESOPHAGUS

Columnar-lined or Barrett's esophagus is a consequence of chronic gast roesophageal reflux and often represents severe reflux disease. Abnorm alities of motility in Barrett's esophagus, therefore, are similar to those in patients with severe reflux esophagitis. Patients with Barret t's esophagus have a high prevalence of defective basal lower esophage al relaxations. Impaired esophageal peristalsis is more common than in patients with mild reflux esophagitis and comparable to patients with severe esophagitis. Systemic diseases associated with impaired esopha geal motility may, as a consequence of chronic gastroesophageal reflux , predispose to Barrett's esophagus. Ln patients with Barrett's esopha gus, there is little evidence that the esophageal motility abnormaliti es improve with either medical therapy or antireflux surgery.