24-HOUR ESOPHAGEAL MOTILITY IN GASTROESOPHAGEAL REFLUX DISEASE (GORD)- INCREASED OCCURRENCE OF SIMULTANEOUS CONTRACTIONS

Impaired oesophageal peristalsis may play a major pathogenetic role in gastro-oesophaegal reflux disease (CORD). Therefore 55 patients with suspected CORD were studied simultaneously by ambulatory 24-hour pH an d pressure monitoring with three pressure transducers (3, 8 and 13 cm above the lower oesophageal sphincter) in order to to test for a relat ionship between oesophageal motility and COR. Twenty-one patients (38% ) had pathological reflux; these patients had significantly more simul taneous contractions than patients without pathological GOR (30.1 +/- 3.3% vs. 19.0 +/- 1.8%, P = 0.002, mean +/- SEM). Further analysis rev ealed a significant difference between groups in the occurrence of sim ultaneous contractions in the mid-oesophagus (33.7 +/- 3.8% vs. 23.9 /- 1.8%, P = 0.012), but not in the distal oesophagus (34.4 +/- 2.7% v s. 33.9 +/- 3.1%, P = 0.90). In addition, a moderate but highly signif icant correlation between the rate of simultaneous contractions and re flux time was found (r = 0.463, P = 0.0005). Mean amplitude and mean d uration of the contractions were no different between groups, neither in the proximal (43.4 +/- 3.3 mmHg vs. 44.9 +/- 1.9 mmHg, P = 0.68 and 2.4 +/- 0.2 s vs. 2.5 +/- 0.1 s, P = 0.50, respectively) nor in the d istal oesophagus (48.8 +/- 4.6 mmHg vs. 54.2 +/- 3.4 mmHg, P = 0.34 an d 3.0 +/- 0.2 s vs. 2.9 +/- 0.2 s, P = 0.71, respectively). It was con cluded that pathological GOR is associated with an increased occurrenc e of simultaneous contractions in the mid, but not in the distal, oeso phagus.