GASTROESOPHAGEAL REFLUX DISEASE IS ASSOCIATED WITH ENTERIC HORMONE ABNORMALITIES

Basal and postprandial levels of the foregut hormones gastrin, cholecy stokinin (CCK), motilin, and pancreatic polypeptide, and the distal gu t hormones neurotensin and peptide YY were measured ire 20 patients wi th gastroesophageal reflux disease (GERD). GERD was defined by abnorma l esophageal exposure to pH less than 4. Ten GERD patients had decreas ed lower esophageal sphincter (LES) pressure (mean: 4.5 mn Hg, range: 0.8 to 6.8 mm Hg), and 10 patients had normal LES pressures (mean: 14. 1 mm Hg, range: 9.7 to 22.4 mm Hg). Eight age-matched healthy subjects were also studied. Basal levels of peptide YY were moderately decreas ed in GERD patients compared with controls irrespective of LES pressur e. In patients with abnormal LES pressure, basal levels of motilin and the postprandial response of CCK were significantly decreased compare d with controls; and basal levels of neurotensin and the postprandial response of gastrin were significantly increased compared with control s. Pancreatic polypeptide levels were similar in all groups. These gut hormone changes, which are more marked in patients with poor LES pres sure, may reflect primary or secondary abnormalities in GERD.