Healing of severe esophagitis improves esophageal peristaltic dysfunction

Reflux esophagitis is frequently associated with peristaltic dysfunction, w hich increases with the severity of inflammatory lesions. In order to asses s peristaltic dysfunction with more accuracy before and after healing, we u sed a 24-hr pH and pressure recording method. Nineteen patients (median age : 65, range: 33-77) with stage II and III (Savary-Miller classification) es ophagitis and peristaltic dysfunction were treated with 40 mg omeprazole fo r three to six months until complete endoscopic healing was achieved. Befor e treatment, median contraction amplitude was significantly lower than medi an contraction amplitude of a control group of comparable age [31 (21-53) v ersus 42 (21-77) mm Hg, P < 0.01], as well as median percentage of peristal tic contractions [27 (16-63) versus 44 (11-56), P < 0.01]. At the end of tr eatment, a statistically significant improvement of esophageal motor functi ons was observed for both median contraction amplitude [38 (26-55), P = 0.0 01] and median percentage of peristaltic waves [45 (23-68), P = 0.0001]. Th e posttreatment values, although still low, were not significantly differen t from control values. In conclusion, complete healing of grade II and III esophagitis improves peristalsis. Inflammatory processes related to severe esophagitis may be involved in failed peristalsis and low contraction ampli tude.