PROSPECTIVE-STUDY OF ESOPHAGEAL MOTOR ABNORMALITIES IN PATIENTS WITH GASTROESOPHAGEAL DISEASE REFLUX ACCORDING TO THE SEVERITY OF ENDOSCOPIC ESOPHAGITIS

Background/Aims: This prospective study evaluates the peristaltic acti vity of the thoracic esophagus in. a group of patients with gastroesop hageal reflux disease, grouping them according to the endoscopic findi ngs. Materials and Methods: The peristaltic activity and the manometri c features of the lower esophageal sphincter were prospectively evalua ted in 109 controls and 321 patients with reflux esophagitis, divided according to the degree of endoscopic esophagitis employing Savary's c lassification. Results: Gastro esophageal sphincter pressure was progr essively lower according to the severity of the tissue damage. Motor p eristaltic activity of the thoracic esophagus measured by several diff erent parameters was significantly altered in Grade IV esophagitis com pared to other groups (p<0.01). The manometric changes were more prono unced at the distal esophagus compared to the proximal esophagus. The percentage of patients with severe motor disturbances, defined as lowe r esophageal sphincter (LES) pressure Less than 6 mm, Less than 50% of peristaltic waves after swallowing and amplitude of contractile waves of less than 50 mmHg were significantly greater in patients with seve re esophageal injury (p<0.001). Conclusion: Gastroesophageal esophagea l reflux may exhibit a wide spectrum of motor disturbances in the dist al part of the esophagus even before the presence of the tissue damage , but it increases in proportion to the severity of endoscopic esophag itis.