MACROSCOPIC HEALING OF ESOPHAGITIS DOES NOT IMPROVE ESOPHAGEAL MOTILITY

The purpose of the present study was to prospectively determine if hea ling of esophagitis as assessed by endoscopy results in improved esoph ageal motility. Thirty-one patients with erosive esophagitis who were randomized to receive either omeprazole 20 mg once daily or placebo co mpleted the double-blind study. All patients underwent endoscopy and e sophageal motility before treatment and at four weeks after treatment. Twenty-two healthy volunteers underwent esophageal manometry and serv ed as normal controls. Manometric tracings were coded, randomized, and analyzed blindly. Compared to normal controls, patients with esophagi tis had significantly lower LESP, decreased amplitude of peristaltic c ontractions, and increased occurrence of abnormal contractions. Omepra zole was superior to placebo in healing of esophagitis. However, heali ng of esophagitis was not associated with any improvement in esophagea l motility. The manometric data suggest that the motility disturbance seen in esophagitis is not secondary to the esophagitis but rather a p rimary phenomenon. The lack of improvement of esophageal motility with healing may explain the high recurrence of esophagitis in clinical tr ials following discontinuation of omeprazole.