TY - JOUR
T1 - Distal Esophageal Hypercontractility Is Related to Abnormal Acid Exposure
AU - Soto-Pérez, Julio César
AU - Sobrino-Cossío, Sergio
AU - Higgins, Paul B.
AU - Comuzzie, Anthony G.
AU - Vargas Romero, Jose Antonio
AU - Reding-Bernal, Arturo
AU - López-Alvarenga, Juan Carlos
PY - 2011/2
Y1 - 2011/2
N2 - Background and Aims: Nutcracker esophagus (NE) is a frequent primary motility disorder of the distal esophagus, and the relationship with acid exposure remains controversial. We studied simultaneous distal esophageal hypercontractility (EH) using two sensors at 8 and 3 cm above the lower sphincter (LES) and abnormal exposure to acid (pH DeMeester score). Methods: From 400 screened patients with chest pain and heartburn, 54 (age 44.5 ± 8.8 years and 74% females) had abnormal manometry and underwent acid exposure measurement. Frequencies of the EH disorder were classic NE (EH3 cm) found in 29 (40.8%) patients, diffuse (EH3,8 cm) in 30 patients (42.3%), and upper segmental (EH8 cm) in 12 patients (16.9%). Results: We found a positive correlation among age with high amplitude in EH3 cm and EH3,8 cm. DeMeester's score (DMS) had the lowest value for EH3,8 cm (2.58 ± 0.23) compared with EH8 cm (3.78 ± 0.3, p <0.003) and EH3 cm (3.12 ± 0.2, p <0.06). Surface response for joint effect of age and DMS on amplitude at EH3 cm confirmed the highest amplitude was for older age and lower DMS. Conclusions: EH3 cm and EH3,8 cm were common for esophageal motility and were inversely associated with DMS. Meanwhile, acid exposure was higher in younger patients and hypercontractility was more frequent in older subjects. The former group may benefit more from proton pump inhibitors and the latter from visceral analgesics or possibly both.
AB - Background and Aims: Nutcracker esophagus (NE) is a frequent primary motility disorder of the distal esophagus, and the relationship with acid exposure remains controversial. We studied simultaneous distal esophageal hypercontractility (EH) using two sensors at 8 and 3 cm above the lower sphincter (LES) and abnormal exposure to acid (pH DeMeester score). Methods: From 400 screened patients with chest pain and heartburn, 54 (age 44.5 ± 8.8 years and 74% females) had abnormal manometry and underwent acid exposure measurement. Frequencies of the EH disorder were classic NE (EH3 cm) found in 29 (40.8%) patients, diffuse (EH3,8 cm) in 30 patients (42.3%), and upper segmental (EH8 cm) in 12 patients (16.9%). Results: We found a positive correlation among age with high amplitude in EH3 cm and EH3,8 cm. DeMeester's score (DMS) had the lowest value for EH3,8 cm (2.58 ± 0.23) compared with EH8 cm (3.78 ± 0.3, p <0.003) and EH3 cm (3.12 ± 0.2, p <0.06). Surface response for joint effect of age and DMS on amplitude at EH3 cm confirmed the highest amplitude was for older age and lower DMS. Conclusions: EH3 cm and EH3,8 cm were common for esophageal motility and were inversely associated with DMS. Meanwhile, acid exposure was higher in younger patients and hypercontractility was more frequent in older subjects. The former group may benefit more from proton pump inhibitors and the latter from visceral analgesics or possibly both.
KW - Chest pain
KW - Esophageal motility disorders
KW - Lower esophageal sphincter
KW - Manometry
KW - Upper esophageal sphincter
UR - http://www.scopus.com/inward/record.url?scp=79955726575&partnerID=8YFLogxK
U2 - 10.1016/j.arcmed.2011.02.003
DO - 10.1016/j.arcmed.2011.02.003
M3 - Article
C2 - 21565622
AN - SCOPUS:79955726575
SN - 0188-4409
VL - 42
SP - 104
EP - 109
JO - Archives of Medical Research
JF - Archives of Medical Research
IS - 2
ER -