AMBULATORY ESOPHAGEAL PRESSURE AND PH MONITORING IN PATIENTS WITH HIGH-GRADE REFLUX ESOPHAGITIS

Using conventional manometry and 24-hr ambulatory pressure and pH moni toring, we investigated esophageal motility and the esophageal motor r esponse to reflux in 11 patients with reflux esophagitis Savary-Miller grade III and IV, and an age- and sex-matched group of 11 healthy con trols. The patients had a significantly increased esophageal acid expo sure. Conventional manometry showed a significantly decreased LES pres sure and distal peristaltic amplitude in patients. The 24-hr monitorin g yielded a significant decrease in peristaltic contraction duration a nd peristaltic propagation velocity in the patient group. Distal peris taltic amplitude was not decreased. Analysis of the contractions occur ring in the 2-min period after each reflux episode showed a reduced nu mber of contractions during the upright period, caused by a significan tly decreased number of peristaltic contractions. During the supine pe riod, there was a trend towards an increased number of contractions, I t is concluded that esophageal motor activity and the response to refl ux are impaired in patients with high-grade reflux esophagitis. Howeve r, the abnormalities found are only minor and are unlikely to play an important role in the pathogenesis of reflux esophagitis.