IS BARRETTS-ESOPHAGUS CHARACTERIZED BY MORE PRONOUNCED ACID REFLUX THAN SEVERE ESOPHAGITIS

Objective: Barrett's esophagus is related to gastroesophageal reflux d isease (GERD). However, only a small fraction of patients with GERD de velop Barrett's esophagus. We evaluated whether gastroesophageal acid reflux is more pronounced in Barrett's patients than in patients,vith moderate or severe endoscopic esophagitis. Methods: Retrospective eval uation of results of esophageal manometry and 24 hour ambulatory pH mo nitoring performed between 1990 and 1996 at the Leiden University Medi cal Center in those patients who also underwent endoscopy less than or equal to 3 months before pH-metry. Included were 51 patients with Bar rett's esophagus, 30 patients with severe esophagitis, 45 patients wit h moderate esophagitis, and 24 healthy control subjects. Results: Pati ents with Barrett's esophagus had significantly increased acid reflux time (p < 0.01-0.05) compared to patients with moderate, but not compa red to patients with severe esophagitis. Distal esophageal body motili ty and LES pressure were significantly (p < 0.01-0.05) reduced in pati ents with Barrett's esophagus compared to patients with moderate esoph agitis but not compared to those with severe esophagitis. Conclusion: Although acid reflux is increased in patients with Barrett's esophagus and esophageal motility is impaired, other factors apart from acid ex posure and motility contribute to the development of Barrett's esophag us. (C) 1998 by Am. Cell. of Gastroenterology.