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Esophageal acid sensitivity in patients with gastroesophageal reflux disease: Does esophageal hypomotility matter?
Author(s) -
Wong MingWun,
Hung JuiSheng,
Lei WeiYi,
Liu TsoTsai,
Yi ChihHsun,
Chen ChienLin
Publication year - 2019
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13700
Subject(s) - reflux , gastroenterology , gerd , medicine , esophageal motility disorder , esophageal ph monitoring , body mass index , esophagus , pathological , disease
Background/Aim Esophageal acid sensitivity plays a role in symptomatic manifestation of gastroesophageal reflux disease (GERD). Esophageal hypomotility is common in patients with GERD. We aimed to determine whether esophageal acid sensitivity may differ between patients with and without esophageal hypomotility. Methods We prospectively enrolled 41 consecutive patients (10 females, mean age 53 years, range 32‐79) with typical reflux symptoms and 10 healthy subjects (5 females, mean age 45 years, range 28‐56) for esophageal acid sensitivity and motility tests. Demographics, body mass index (BMI), and reflux symptoms using a validated questionnaire (GERDQ) were recorded. All subjects underwent infusion of 0.1 N hydrochloric acid in the esophagus at a rate of 10 mL/min for 10 minutes. The parameters for esophageal acid infusion included lag time, intensity rating, and acid sensitivity score. Results Esophageal motility diagnosis included 24 patients with normal motility and 17 patients with ineffective esophageal motility (IEM). Lag time was similar between the patient groups. No differences between patients with normal motility and IEM were found for any of other acid infusion parameters. There was a positive correlation between lag time and BMI ( r = .33, P = .04). GERDQ was negatively correlated to lag time ( r = −.73, P < .001). Conclusions Esophageal acid sensitivity was similar in GERD patients with and without hypomotility. Decreased acid sensitivity in individuals with increasing body mass index may play a pathological role in symptomatic modulation of patients with GERD.