Is Motility Impaired in the Entire Upper Gastrointestinal Tract in Patients with Gastro-oesophageal Reflux Disease?

Abstract

Background: Although the pathogenesis of gastro-oesophageal reflux disease is multifactorial, abnormal function of the lower oesophageal sphincter has been established, and in some cases motility defects in the oesophageal body has been described. In some patients with gastro-oesophageal reflux disease delayed gastric emptying has also been observed. Methods: Oesophageal and gastric motor function, as evaluated by use of scintigraphy and manometry, were studied concomitantly in 105 patients with chronic, gastro-oesophageal reflux disease before and after antireflux surgery. In a subgroup of these patients (n = 29) similar data were retrieved also at 2.7 years after antireflux surgery. Results: Impaired oesophageal motor function expressed as delayed transit of a labelled bolus was closely associated with motor dysfunction also recorded in the stomach as determined by delayed emptying of labelled solid food items. A similar relationship was found when oesophageal motor dysfunction was characterized as the frequency of failed primary peristalses after water swallows during manometry. When the 105 patients were studied half a year after an antireflux operation, no correlation between oesophageal and gastric motor function could be recorded. Conclusions: These data further substantiate the view that gastro-oesophageal reflux disease is associated with a disturbed motor function within the entire upper gastrointestinal tract.

Key Words:

• Gastro-oesophageal reflux disease
• liquid gastric emptying
• lower oesophageal sphincter
• oesophageal emptying
• oesophageal manometry
• oesophagitis
• solid gastric emptying