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- Title
Ineffective Esophageal Motility: The Most Common Motility Abnormality in Patients With GERD-Associated Respiratory Symptoms.
- Authors
Fouad, Yasser M.; Katz, Philip O.; Hatlebakk, Jan G.; Castell, Donald O.
- Abstract
OBJECTIVE: The association of gastroesophageal reflux disease (GERD) and respiratory symptoms is well known. The coexistence of ineffective esophageal motility (IEM. low-amplitude [<30 mm Hg] or nontransmitted contractions in ≥30% of 10 wet swallows in the distal esophagus) in patients with GERD has recently been demonstrated. Our aim was to determine the prevalence of IEM in patients with GERD-associated respiratory symptoms. METHODS: Manometry and pH studies of 98 consecutive patients with respiratory symptoms and abnormal reflux shown by pH-metry were reviewed. Symptoms were chronic cough (n = 43). asthma (n = 13), and laryngitis (n = 42). Sixty-six patients with heartburn with no extraesophageal manifestations were used as a control group. Total esophageal acid clearance (EAC) time was calculated for each patient. RESULTS: IEM was the most common motility abnormality seen in all groups of GERD patients. It was seen significantly more often in patients with chronic cough (41%) (<em>p</em> = 0.003) or asthma (53%) (<em>p</em> = 0.01), and numerically more often in patients with laryngitis (31%) than in patients with heartburn (19%). Diffuse esophageal spasm and nutcracker esophagus were rarely seen. Incidence of hypertensive or hypotensive lower esophageal sphincter was similar across all groups. The total EAC time was longer (median: 1.51 min/episode) (<em>p</em> = 0.01) in patients with GERD-associated respiratory symptoms than in patients with heartburn (median: 0.72 min/episode). CONCLUSIONS: IEM is the most prevalent motility abnormality in patients with GERD-associated respiratory symptoms. Coexistence of IEM with GER may place patients at high risk for respiratory symptoms due to the associated delayed esophageal acid clearance seen with this motility abnormality.
- Subjects
GASTROESOPHAGEAL reflux; RESPIRATORY diseases; ESOPHAGEAL motility disorders; MANOMETERS; SPASMS
- Publication
American Journal of Gastroenterology (Springer Nature), 1999, Vol 94, Issue 6, p1464
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.1999.1127_e.x