Distal Esophageal Hypercontractility Is Related to Abnormal Acid Exposure

• Published in: Archives of medical research 2011-02, Vol.42 (2), p.104-109
• Main Authors: Soto-Pérez, Julio César, Sobrino-Cossío, Sergio, Higgins, Paul B, Comuzzie, Anthony G, Vargas Romero, Jose Antonio, Reding-Bernal, Arturo, López-Alvarenga, Juan Carlos
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Chest pain; Esophageal motility disorders; Esophageal Motility Disorders - complications; Esophageal Motility Disorders - pathology; Esophageal Motility Disorders - physiopathology; Esophageal Sphincter, Lower - physiopathology; Female; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - pathology; Gastroesophageal Reflux - physiopathology; Humans; Hydrogen-Ion Concentration; Internal Medicine; Lower esophageal sphincter; Male; Manometry; Middle Aged; Pressure; Upper esophageal sphincter
• ISSN: 0188-4409; 1873-5487
• DOI: 10.1016/j.arcmed.2011.02.003

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