ESOPHAGEAL MOTILITY AND GASTROESOPHAGEAL REFLUX BEFORE AND AFTER HEALING OF REFLUX ESOPHAGITIS - A STUDY USING 24-HOUR AMBULATORY PH AND PRESSURE MONITORING

In this study 24 hour oesophageal pH and pressure monitoring was used to assess oesophageal motility and acid clearance in 27 patients with reflux oesophagitis (Savary-Miller grades I-TV), before and after heal ing of oesophagitis. After the first 24 hour study patients were treat ed with omeprazole 40 mg for 8-24 weeks. After endoscopically verified healing and withdrawing omeprazole for four days 24 hour monitoring w as repeated. A total of 106 630 pressure events was analysed. No signi ficant differences were found for any of the motility variables, espec ially the number and the type of contractions, the peristaltic amplitu de, duration, and propagation velocity did not show any changes. Separ ate analysis of motility variables before and after healing in the low and high grade oesophagitis groups yielded similar results. Oesophage al motor response to reflux was investigated by analysis of all contra ctions occurring in the two minute period after the onset of each refl ux episode. Both motor response and oesophageal acid exposure (% time pH < 4, number of reflux episodes) did not change after healing of oes ophagitis, thus implying that acid clearance remained unchanged. These results indicate that impaired motility in reflux oesophagitis is eit her an irreversible consequence of oesophageal inflammation, or a (pre -existent) factor in its pathogenesis.