ESOPHAGEAL APERISTALSIS AND GASTROESOPHAGEAL REFLUX DISORDER - RETURNOF PERISTALSIS AFTER H2-BLOCKER THERAPY

Objectives: Distal esophageal aperistalsis has rarely been reported am ong patients with gastroesophageal reflux disorder. The purpose of thi s study, therefore, was to address the frequency with which disorders of peristalsis in general-and distal esophageal aperistalsis in partic ular-occur in adults with gastroesophageal reflux disorder. Patients a nd Methods: We studied 314 patients who were referred to our gastroint estinal motility laboratory. On the basis of the endoscopic data, they were divided into three groups: group I, symptomatic patients without endoscopic esophagitis; group II, patients with mild endoscopic esoph agitis; and group III, patients with erosive esophagitis. An age-match ed group of patients with chest pain unrelated to reflux served as the control. Results: Some form of peristaltic dysfunction was recorded i n 56% of the patients with gastroesophageal reflux disorder, significa ntly more than in the control group (p < 0.01). A significant correlat ion existed between the esophageal motor dysfunction scores and the se verity of reflux disease. Distal esophageal aperistalsis was present i n 3.1% of the reflux groups, There was a correlation between severity of reflux disease and the prevalence of aperistalsis. Aperistalsis occ urred in none of the patients in group I, in 3.6% of group II, and in 12.5% of group III (p < 0.0001). Seven of the patients with aperistals is who has been treated with H2-blockers were reexamined 4 months late r. Return of peristalsis was seen in three of them. Conclusion: Esopha geal aperistalsis can be seen in a minority of patients with severe ga stroesophageal reflux disorder and is probably a reversible condition.