Esophageal Manometry Findings of the Patients with Gastric Mucosal Prolapse

Lee, Joon Seong; Chun, Gab Jin; Hong, Su Jin; Moo, Jong Ho; Kim, Jin Oh; Cho, Young Deok; Cho, Joo Young; Lee, Moon Sung; Shim, Chan Sup

Abstract

BACKGROUND/AIMS: The purpose of this study was to investigate the roles of the abnormalities of lower esophageal sphincter (LES) and esophageal body as a factor of gastric mucosal prolapse (GMP).
METHODS
Ninety-one patients were classified into the GMP group (n=51) and control group (n=40). They had a routine esophageal manometry. Fourteen patients of GMP group and 18 normal controls had a dynamic study to assess the effect of routine endoscopic premedication such as atropine sulfate and scopolamine butylbromide.
RESULTS
The mean pressure of LES in GMP group was similar to that in the control group (22.99+/-9.97 mmHg vs 25.46+/-7.92 mmHg). LES length of the GMP group was shorter than that of the control group (3.33+/-0.73 mm vs 3.88+/-0.78 mm, p<0.05), but errors in measurement should be considered. Other parameters such as mean amplitude, duration and velocity of the peristaltic waves in esophageal body were not different in the both groups. By the findings of endoscopy and manometry, GMP was accompanied by redundant gastric mucosa of fundus or upper body (51/51), hiatal hernia (9/51), nutcracker esophagus (2/51), hypertensive LES (1/51) and nonspecific esophageal motor disturbance (NEMD) (5/51). In the dynamic study, the mean basal pressures of LES were significantly decreased after premedication in both groups (p<0.05), and the percentage of pressure reduction in both groups was similar (71.93+/-6.16% vs 73.56+/-10.61%).
CONCLUSIONS
The pathogenesis of the gastric mucosal prolapse was not associated with a decrease of LES pressure and sensitivity for premedication. It may be caused mainly by redundancy of gastric mucosa, and partially by hiatal hernia.