ABSTRACT
Objective To analyze the relationship between body type,age,gender,esophageal motility function,lower esophageal sphincter pressure (LESP) and clinical classification and type of reflux contents of patients with gastroesophageal reflux disease (GERD).Methods From September 2015 to July 2016,at Beijing Tongren Hospital of China Capital Medical University,the results of 24-hour esophageal impedance-pH monitoring of 141 patients with GERD were retrospectively analyzed.The differences of reflux contents were compared in patients with GERD among different body type,age,gender,esophageal motility function,LESP and clinical classification.Mann-Whitney test was performed for comparison between groups.Results Acid reflux was more common in obese patients (body mass index more than 23.9 kg/m2) compared with patients with normal body type (body mass index from 18.5 to 23.9 kg/m2) (18.5,7.0 to 45.3 vs.10.0,2.0 to 32.0),and the difference was statistically significant (Z =-2.320,P =0.020).Patients under 65 years old had more numbers of weak acid reflux,non-acid reflux and gas reflux than patients over 65 years old (58.5,32.8 to95.0 vs.40.0,24.0to71.0;19.5,6.0to47.5 vs.8.0,3.0 to19.0;46.0,23.8to79.3 vs.35.0,11.0 to 56.0),and the differences were statistically significant (Z =-2.690,-3.286 and-2.091,all P＜0.05).Male patients had more gas and mixed reflux compared with female patients (53.5,24.0 to 122.8 vs.36.0,19.0 to 67.0;34.0,20.8 to 50.0 vs.27.0,14.0 to 43.0),and the differences were statistically significant (Z =-2.424 and-1.961,both P ＜ 0.05).There was no statistically significant difference in reflux contents between patients with normal esophageal motility and patients with esophageal motility disorder (weak or interrupted peristalsis) (all P ＞ 0.05).Patients with reflux esophagitis(RE) and/or Barrett's esophagus (BE) had more weak acid reflux,non-acid reflux and gas reflux compared with patients with non-erosive reflux disease (NERD) (61.0,31.3 to 102.5 vs.44.0,24.5 to 66.5;18.0,8.0 to 36.5 vs.8.0,2.0 to 22.0;49.5,27.5 to 86.5 vs.26.0,11.0 to 47.0),and the differences were statistically significant (Z =-2.585,-2.942 and-3.278,all P ＜ 0.05).Patients with lower esophageal sphincter (LES) relaxation were more likely to have weak acid reflux than patients with normal LES function (57.0,32.3 to 87.0 vs.40.0,21.0 to 73.0),the difference was statistically significant (Z =-2.065,P =0.039).Conclusion Body type,age,gender,LESP and clinical classification are related to type of reflux contents in GERD patients,while esophageal peristalsis is irrelevant.
ABSTRACT
Background:Besides typical gastroesophageal reflux symptoms,some reflux esophagitis( RE)patients also complain“morning sour taste in mouth”,but related studies are rare. Aims:To study the pathophysiology of RE with sour taste in mouth. Methods:Fifty-two RE patients with typical regurgitation symptom and confirmed by endoscopy from Mar. 2013 to Oct. 2013 at Tianjin Medical University General Hospital were enrolled. Patients were divided into two groups according to whether there was an existence of morning sour taste in mouth. Results of esophageal manometry and 24-hour esophageal impedance-pH monitoring were analyzed. Nine healthy volunteers who had esophageal manometry performed were served as controls. Results:Length of lower esophageal sphincter( LESL)was shortened and LES pressure( LESP)and effective peristalsis of esophageal body were decreased in both RE groups when compared with controls( P ﹤ 0. 05 ). Upper esophageal sphincter pressure( UESP)was significantly lower and more nocturnal reflux episodes occurred in RE group with sour taste than those without( P ﹤ 0. 05 );however,no significant differences in other manometric and reflux parameters were found between RE groups with and without sour taste(P﹥0. 05). Conclusions:Esophageal motility and reflux events in RE patients with morning sour taste in mouth are somewhat different from those without sour taste. Decrease in UESP might be an important pathophysiological mechanism of sour taste in mouth in RE patients.