Characteristics of esophageal motility in patients with upper or lower-esophageal reflux

Objective To explore the characteristics of esophageal motility in patients with upper or lower-esophageal reflux, and analyze esophageal motility changes in patients with esophageal reflux disease (GERD) or laryngopharyngeal reflux disease (LPRD). Methods Retrospective analysis was carried out in 40 patients with GER symptoms. All of these patients underwent 24 hours dualprobe pH monitoring of esophagus and high-resolution manometry (HRM) at the same time. Then the outcomes of these patients were collected and the patients were divided into four groups according to different esophageal reflux types, and the HRM parameters were compared between four groups. Results There were 9 patients with both lower and upper-esophageal reflux (group A, 4 males and 5 females with age ranging from 35-74 years), 8 patients with upper-esophageal reflux only (group B, 3 males and 5 females with age ranging from 40-57 years), 11 patients with lower-esophageal reflux only (group C, 4 males and 7 females with age ranging from 33-74 years), and 12 patients without pathologic gastroesophageal reflux (control group, 4 males and 8 females with age ranging from 29-62 years). The lower esophageal sphincter pressure (LESP) of patients in group A, B, C were significantly lower than control group (16.86±6.84) mmHg, (17.36±8.74) mmHg, (20.91±16.01) mmHg vs (30.73±12.39) mmHg, P＜ 0.05, and the abdominal LES length of patients in group A, B, C was significantly shorter than control group (0.50, 1.75-0.05) cm, (0.48, 1.12-0.12)cm, (0.56, 1.95-0.15) cm vs (1.85, 2.75-0.20) cm, P＜ 0.05. The recovery time of upper esophageal sphincter (UES) relaxation of patients in group A and B was significantly shorter than control group (434.22±177.81) ms, (423.00±93.00) ms vs (559.75±130.48) ms, P＜ 0.05. The number of patients with motility abnormalities in esophageal body only or hiatal hernia only or both of the two diseases in group A (n=1, 2, 4), B (n=1, 0, 4), C (n=2, 2, 4) was more than control group (n=0, 0, 1). Conclusion The decrease of LESP, motility abnormalities in esophageal body and hiatal hernia are closely related to both GERD and LPRD.