Esophageal acid clearance in patients with ineffective esophageal motility

Kim, Gwang Ha; Bae, Yong Mock; Jeong, Eul Jo; Moon, Jae Hyeon; An, Jin Kwang; Kim, Jin Seon; Heo, Jeong; Kang, Dae Hwan; Song, Geun Am; Cho, Mong; Yang, Ung Suk

Abstract

BACKGROUND: Failed or hypotensive peristalsis, two of the diagnostic criteria for NEMD, correlates with impaired anterograde propulsion and retrograde escape of esophageal contents. The aim of this study was to evaluate esophageal acid clearance (EAC) in patients with ineffective esophageal motility (IEM).
METHODS
Of 252 patients performing esophageal manometry and ambulatory esophageal pH monitoring, 51 patients with normal motility and acid reflux and 40 patients with IEM and acid reflux were included.
RESULTS
The amplitude of peristaltic waves in the proximal and distal esophagus and lower esophageal sphincter pressure was lower significantly in patients with IEM than those with normal motility. Percentage of time of pH<4 in total, upright, and supine period and number of reflux episodes was not different in both. Supine EAC was significantly increased in patients with IEM when compared to those with normal motility. Upright EAC was not different in both.
CONCLUSION
We concluded supine EAC is increased in patients with IEM. Since IEM is frequently associated with gastroesophageal reflux disease (GERD), a more intensive therapy must be needed. We propose IEM can be as a specific entity of primary esophageal motility disorder, especially in patients with GERD.