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Supine GERD patients with large breaks experienced higher acid exposure, prolonged bolus clearance
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Patients with gastroesophageal reflux disease and large peristaltic breaks displayed prolonged reflux clearance while in a supine position and greater acid exposure time in a recent study.
Researchers used high-resolution manometry to study the esophageal motility of 40 patients (mean age, 44 years; 26 women) with recurrent gastroesophageal reflux disease (GERD) symptoms but no evidence of hiatal hernia. All patients had at least two incidents of vomiting weekly and/or heartburn that lasted for more than 6 months.
Patients’ extended breaks of esophageal peristalis and delayed bolus clearance also were measured by 24-hour multichannel impedance-pH to determine if a relationship existed. Both total bolus clearing time, while patients were in upright and supine positions, and acid exposure time (AET) were assessed during the 1-year study.
Among the GERD patients, 23 displayed a pathological AET (mean, 10.8%), while the others exhibited normal pH. Fifteen of the patients had erosive reflux disease (ERD), including 10 who had an abnormal number of small or large breaks (P<.05).
Researchers determined that patients who had an excessive number of esophageal peristalsis breaks, assessed by manometry, had significantly longer prolonged reflux clearance while in the supine position along with greater AET. Patients with ERD exhibited more esophageal breaks, which researchers said, may possibly cause erosions.
“These findings might explain, if confirmed by outcome studies, that weak peristalsis … together with other factors, is involved in the development of erosions of the esophageal mucosa and further confirm the need [for] more effective prokinetic drugs,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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