Secondary oesophageal peristalsis in gastro-oesophageal reflux disease

Background and Aims: To evaluate the status of secondary oesophageal perist alsis in gastro-oesophageal reflux disease (GORD) and the effect of healing of oesophagitis on these abnormalities. Methods: Twenty-one patients diagnosed with GORD and 10 control subjects in the same age group were studied. Primary peristalsis was elicited by 10 5 mL water boluses and secondary peristalsis by 10 20 mL boluses of air injec ted 15 cm above the lower oesophageal sphincter. Results: The pattern of primary peristalsis was normal in a significantly l ower number of patients compared with control subjects, six patients (28.6% ) versus seven controls (70%), (P < 0.05). Similarly, the number of subject s with a normal pattern of secondary peristalsis was also lower in the pati ent group (zero vs three; P < 0.05). A normal primary peristaltic response occurred with 71 (33.8%) of the 210 water boluses in the patients and 73 (7 3%) of the 100 water boluses in the control subjects, respectively (P < 0.0 01). A normal secondary peristaltic response was seen with 15 (7.1%) of 210 air boluses in patients and 32 (32%) of 100 air boluses in the control sub jects (P < 0.001). The amplitude of secondary peristaltic waves and the dur ation of contraction (mean +/- SEM) were significantly lower in patients co mpared with the control subjects (43.5 +/- 4.7 vs 89.0 +/- 13.1 and 3.4 +/- 0.8 vs 3.9 +/- 0.3, respectively; P = < 0.05). In the 13 patients in whom repeat evaluation was performed after healing of oesophagitis, there was no significant change in the number of patients with normal peristaltic respo nse, number of normal responses to air and water boluses, or amplitude, dur ation and velocity of peristalsis. Conclusion: Significant abnormalities of secondary oesophageal peristalsis occur in patients with GORD and these are not reversed by healing of oesoph agitis. (C) 2000 Blackwell Science Asia Pty Ltd.