Effect of Abrupt Esophageal Provocation on Sensory-Motor Characteristics of Esophageal Body and Upper Esophageal Sphincter (UES) Contractile Reflexes in Infants With Gastroesophageal Reflux Disease (GERD)

CONTEXT: Gastroesophageal reflux disease is a chronic disease in which gastroduodenal contents reflux into the esophagus. The clinical picture of gastroesophageal reflux disease is usually composed by heartburn and regurgitation (typical manifestations). Atypical manifestations (vocal disturbances and asthma) may also be complaint. OBJECTIVE: To analyse the clinical, endoscopic, manometric and pHmetric aspects of patients suffering from gastroesophageal reflux disease associated with vocal disturbances. METHODS: Fifty patients with gastroesophageal reflux disease were studied, including 25 with vocal disturbances (group 1 - G1) and 25 without these symptoms (group 2 - G2). All patients were submitted to endoscopy, manometry and esophageal pHmetry (2 probes). The group 1 patients were submitted to videolaryngoscopy. RESULTS: Endoscopic findings: non-erosive reflux disease was observed in 95% of G1 patients and 88% of G2. Videolaryngoscopy: vocal fold congestion, asymmetry, nodules and polyps were observed in G1 patients. Manometric findings: pressure in the lower esophageal sphincter (mm Hg): 11.6 ± 5.2 in G1 and 14.0 ± 6.2 in G2 (P = 0.14); pressure in the upper esophageal sphincter (mm Hg): 58.4 ± 15.9 in G1 and 69.5 ± 30.7 in the controls. pHmetric findings: De Meester index: 34.0 ± 20.9 in G1 and 15.4 ± 9.4 in G2 (P<0.001); number of reflux episodes in distal probe: 43.0 ± 20.4 in G1 and 26.4 ± 17.2 in G2 (P = 0.003); percentage of time with esophageal pH value lower than 4 units (distal sensor): 9.0% ± 6.4% in G1 and 3.4% ± 2.1% in G2 (P<0.001); number of reflux episodes in proximal probe: 7.5 ± 10.9 in G1 and 5.3 ± 5.7 in G2 (P = 0.38); percentage of time with esophageal pH values lower than 4 units (Proximal probe): 1.2 ± 2.7 in G1 and 0.5 ± 0.7 in G2 (P = 0.21). CONCLUSIONS: 1) The clinical, endoscopic, and manometric findings observed in patients with vocal disturbance do not differ from those without these symptoms; 2) gastroesophageal reflux intensity is higher in patients with vocal disturbance; 3) patients without vocal disturbance can also present reflux episodes in the proximal probe.

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Upper Esophageal Sphincter (UES) Abnormalities Assessed by High Resolution Esophageal Manometry (HREM) in Patients With Gastroesophageal Reflux Disease (GERD) and Laryngopharyngeal Reflux (LPR)

The American Journal of Gastroenterology ◽

10.14309/00000434-201510001-01697 ◽

2015 ◽

Vol 110 ◽

pp. S720-S721

Author(s):

Shamiq Zackria ◽

Rocio Lopez ◽

Prashanthi Thota

Keyword(s):

High Resolution ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Esophageal Manometry ◽

Laryngopharyngeal Reflux ◽

Upper Esophageal Sphincter ◽

Esophageal Sphincter

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ORAL AND PHARYNGEAL TRANSIT IN FUNCTIONAL HEARTBURN

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202000000-28 ◽

2020 ◽

Vol 57 (2) ◽

pp. 150-153

Author(s):

Rachel Aguiar CASSIANI ◽

Roberto Oliveira DANTAS

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Transit Time ◽

Reflux Disease ◽

Upper Esophageal Sphincter ◽

Functional Heartburn ◽

Solid Foods ◽

Esophageal Sphincter ◽

Pharyngeal Transit ◽

Mild Dysphagia

ABSTRACT BACKGROUND: Gastroesophageal reflux disease is associated with slower transit of the bolus through the pharynx and upper esophageal sphincter. Functional heartburn has similar symptoms to gastroesophageal reflux disease, however, the symptoms are not caused by reflux. OBJECTIVE: The aim of this investigation was to evaluate oral and pharyngeal transit in patients with functional heartburn, with the hypothesis that, similar to patients with gastroesophageal reflux disease, they have changes in pharyngeal and upper esophageal sphincter transit time. METHODS: Oral and pharyngeal transit was evaluated by videofluoroscopy in eight women with functional heartburn, five with mild dysphagia for solid foods, and 12 female controls. Controls and patients swallowed in duplicate 5 mL and 10 mL of liquid and paste boluses. RESULTS: No difference in the oral or pharyngeal transit time was found between patients and controls. No aspiration of bolus into the airways was detected in any individual. Pharyngeal residues were detected in the same proportion of swallows, in patients (12.5%) and controls (15.0%), after swallows of 10 mL paste bolus. CONCLUSION: Oral, pharyngeal and upper esophageal sphincter transit time are similar in patients with functional heartburn to healthy controls.

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