Skip to main content
SpringerLink
Log in

Esophageal motor function and response to acid perfusion in patients with symptomatic reflux esophagitis

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

There is much evidence to suggest that peristaltic function is defective in esophagitis patients and that this defect may contribute to prolonged acid exposure, promoting esophageal mucosal injury. Abnormal peristalsis may also be related to the generation of reflux symptoms. We evaluated primary peristalsis and its relationship to symptoms under basal conditions and during saline and HCl perfusion in 15 symptomatic reflux patients with gross esophagitis and 15 healthy controls. In the basal state, LES pressure (15.3 vs 25.1 mm Hg) and peristaltic amplitude (74.2 vs 104.8 mm Hg) were significantly lower in subjects with gastroesophageal reflux disease (GERD) (P<0.05). During HCl perfusion, peristaltic amplitude and duration increased slightly, and peristaltic velocity slightly decreased similarly in both groups. There was no difference in the incidence of nonpropagated, segmental, or swallow-initiated simultaneous contractions, or change in resting intraesophageal pressure during HCl perfusion in control and GERD groups. This study identified abnormal contractile amplitude as a specific defect in the primary peristaltic wave of esophagitis patients but does not support a role for acid-induced motility changes in the generation of symptoms in GERD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Orr WC, Robinson MG, Johnson LF: Acid clearing during sleep in patients with esophagitis and controls. Dig Dis Sci 26:423–427, 1981

    Google Scholar 

  2. Atkinson M, VanGelden A: Esophageal intraluminal pH recording in the assessment of gastroesophageal reflux and its consequences. Am J Dig Dis 22:365–370, 1977

    Google Scholar 

  3. Booth DJ, Kammerer WT, Skinner DB: Acid clearing from the distal esophagus. Arch Surg 96:731–734, 1968

    Google Scholar 

  4. Phaosawasdi K, Malmud LS, Tolin RD, Stelzer F, Applegate G, Fisher RS: Cholinergic effects on esophageal transit and clearance. Gastroenterology 81:915–920, 1981

    Google Scholar 

  5. McCallum RW, Berkowitz DM, Lerner E: Gastric emptying in patients with gastroesophageal reflux. Gastroenterology 80:285–291, 1981

    Google Scholar 

  6. Ahtaridis G, Snape WJ, Cohen S: Clinical and manometric findings in benign peptic strictures of the esophagus. Dig Dis Sci 24:858–861, 1979

    Google Scholar 

  7. Nagler R, Spiro HM: Heartburn in late pregnancy. Manometric studies of esophageal motor function. J Clin Invest 40:954–970, 1961

    Google Scholar 

  8. Tuttle SG, Rufin F, Bittarello A: The physiology of heart-burn. Ann Intern Med 55:292–300, 1961

    Google Scholar 

  9. Siegel CF, Hendrix TR: Esophageal motility abnormalities induced by acid perfusion in patients with heart burn. J Clin Invest 42:686–695, 1963

    Google Scholar 

  10. Atkinson M, Bennett JR: Relationship between motor changes and pain during esophageal acid perfusion. Am J Dig Dis 13:346–350, 1968

    Google Scholar 

  11. Donner MW, Silbiger ML, Hookman P, Hendrix TL: Acid barium swallow in the radiographic evaluation of clinical esophagitis. Radiology 87:220–225, 1966

    Google Scholar 

  12. Olsen AM, Schlegel JF: Motility disturbances caused by esophagitis. J Thorac Cardiovasc Surg 50:607–612, 1965

    Google Scholar 

  13. Arndorfer RC, Stef JJ, Dodds WJ, Linehan JH, Hogan WJ: Improved perfusion system for intraluminal esophageal manometry. Gastroenterology 73:23–27, 1977

    Google Scholar 

  14. Dodds WJ: Instrumentation and methods for intraluminal esophageal manometry. Arch Intern Med 136:515–523, 1976

    Google Scholar 

  15. Stanciu C, Bennett JR: Esophageal acid clearing: One factor in the production of reflux esophagitis. Gut 15:852–857, 1975

    Google Scholar 

  16. Johnson LF, DeMeester TR, Haggitt RC: Esophageal epithelial response to gastroesophageal reflux. A quantitative study. Am J Dig Dis 23:498–509, 1978

    Google Scholar 

  17. Goldberg HI, Dodds WJ, Montgomery C, Baskin SA, Zboralske FF: Controlled production of acute esophagitis. Invest Radiol 5:254–256, 1970

    Google Scholar 

  18. Dodds WJ, Goldberg HI, Montgomery C, Ludemann WB, Zboralske FF: Sequential gross, microscopic, and roentgenographic features of acute feline esophagitis. Invest Radiol 5:209–219, 1970

    Google Scholar 

  19. Texter EC, Jr: Discussion at 60th Annual Meeting of American Gastroenterological Association, cited in Gastroenterology 38:844, 1960

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Section on Gastroenterology, Ochsner Clinic, 70121, New Orleans, Louisiana

    Theodore W. Burns MD & Steve G. Venturatos MD

  2. Alton Ochsner Medical Foundation, 70121, New Orleans, Louisiana

    Theodore W. Burns MD & Steve G. Venturatos MD

Authors
  1. Theodore W. Burns MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steve G. Venturatos MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This study was supported in part by a grant from the Mary E. Peters and Robert W. Polchow Foundation and the Alton Ochsner Medical Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Burns, T.W., Venturatos, S.G. Esophageal motor function and response to acid perfusion in patients with symptomatic reflux esophagitis. Digest Dis Sci 30, 529–535 (1985). https://doi.org/10.1007/BF01320258

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01320258

Keywords

Search

Navigation