Ineffective motility is not a marker for gastroesophageal reflux disease

Elango Vinjirayer, Begona Gonzalez, Colleen Brensinger, Nicole Bracy, Robin Obelmejias, David A Katzka, David C. Metz

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

OBJECTIVE: Previous studies have suggested that ineffective esophageal motility (IEM) may be a marker for gastroesophageal reflux disease (GERD), particularly supraesophageal reflux disease. We evaluated the relationship between esophageal acid exposure and esophageal body motility in patients undergoing both esophageal manometry and 24-h pH metry in the absence of antisecretory therapy. METHODS: We conducted a retrospective database review of 84 patients (mean age 47 yr, 46% male) evaluated in our GI physiology laboratory. The indication for testing was recorded and characterized as esophageal or supraesophageal. Abnormal esophageal acid exposure was defined as a distal esophageal pH <4 for more than 4.2% of the total monitoring time (>6.3% upright, >1.2% supine) or a proximal esophageal acid exposure time of greater than 1.1% total (>1.3% upright, 0% supine). IEM was defined as more than two of 10 ineffective peristaltic waves. RESULTS: Seventy-two patients had esophageal-presenting symptoms, and 12 had supraesophageal symptoms. The prevalence of abnormal esophageal acid exposure was similar in patients with esophageal and supraesophageal symptoms (69% vs 92%, p = 0.17). Abnormal motility was identified in 26 patients (31%). IEM was the most common motility disturbance (77%, 20 patients). The frequency of motility disorders was similar in patients with and without abnormal esophageal acid exposure (30% vs 35%, p = 0.79), in patients with esophageal or supraesophageal symptoms (32% vs 25%, p = 0.75, for all patients; 30% vs 27%, p = 1.00, for patients with abnormal esophageal acid exposure), and among upright, supine, and combined refluxers (33%, 9%, and 35%, p = 0.26). CONCLUSIONS: IEM does not stand alone as a significant marker for the presence of GERD in general or supraesophageal reflux disease in particular.

Original languageEnglish (US)
Pages (from-to)771-776
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume98
Issue number4
DOIs
StatePublished - Apr 1 2003
Externally publishedYes

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Gastroesophageal Reflux
Acids
Manometry
Databases

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Vinjirayer, E., Gonzalez, B., Brensinger, C., Bracy, N., Obelmejias, R., Katzka, D. A., & Metz, D. C. (2003). Ineffective motility is not a marker for gastroesophageal reflux disease. American Journal of Gastroenterology, 98(4), 771-776. https://doi.org/10.1111/j.1572-0241.2003.07391.x

Ineffective motility is not a marker for gastroesophageal reflux disease. / Vinjirayer, Elango; Gonzalez, Begona; Brensinger, Colleen; Bracy, Nicole; Obelmejias, Robin; Katzka, David A; Metz, David C.

In: American Journal of Gastroenterology, Vol. 98, No. 4, 01.04.2003, p. 771-776.

Research output: Contribution to journalArticle

Vinjirayer, E, Gonzalez, B, Brensinger, C, Bracy, N, Obelmejias, R, Katzka, DA & Metz, DC 2003, 'Ineffective motility is not a marker for gastroesophageal reflux disease', American Journal of Gastroenterology, vol. 98, no. 4, pp. 771-776. https://doi.org/10.1111/j.1572-0241.2003.07391.x
Vinjirayer, Elango ; Gonzalez, Begona ; Brensinger, Colleen ; Bracy, Nicole ; Obelmejias, Robin ; Katzka, David A ; Metz, David C. / Ineffective motility is not a marker for gastroesophageal reflux disease. In: American Journal of Gastroenterology. 2003 ; Vol. 98, No. 4. pp. 771-776.
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abstract = "OBJECTIVE: Previous studies have suggested that ineffective esophageal motility (IEM) may be a marker for gastroesophageal reflux disease (GERD), particularly supraesophageal reflux disease. We evaluated the relationship between esophageal acid exposure and esophageal body motility in patients undergoing both esophageal manometry and 24-h pH metry in the absence of antisecretory therapy. METHODS: We conducted a retrospective database review of 84 patients (mean age 47 yr, 46{\%} male) evaluated in our GI physiology laboratory. The indication for testing was recorded and characterized as esophageal or supraesophageal. Abnormal esophageal acid exposure was defined as a distal esophageal pH <4 for more than 4.2{\%} of the total monitoring time (>6.3{\%} upright, >1.2{\%} supine) or a proximal esophageal acid exposure time of greater than 1.1{\%} total (>1.3{\%} upright, 0{\%} supine). IEM was defined as more than two of 10 ineffective peristaltic waves. RESULTS: Seventy-two patients had esophageal-presenting symptoms, and 12 had supraesophageal symptoms. The prevalence of abnormal esophageal acid exposure was similar in patients with esophageal and supraesophageal symptoms (69{\%} vs 92{\%}, p = 0.17). Abnormal motility was identified in 26 patients (31{\%}). IEM was the most common motility disturbance (77{\%}, 20 patients). The frequency of motility disorders was similar in patients with and without abnormal esophageal acid exposure (30{\%} vs 35{\%}, p = 0.79), in patients with esophageal or supraesophageal symptoms (32{\%} vs 25{\%}, p = 0.75, for all patients; 30{\%} vs 27{\%}, p = 1.00, for patients with abnormal esophageal acid exposure), and among upright, supine, and combined refluxers (33{\%}, 9{\%}, and 35{\%}, p = 0.26). CONCLUSIONS: IEM does not stand alone as a significant marker for the presence of GERD in general or supraesophageal reflux disease in particular.",
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AU - Vinjirayer, Elango

AU - Gonzalez, Begona

AU - Brensinger, Colleen

AU - Bracy, Nicole

AU - Obelmejias, Robin

AU - Katzka, David A

AU - Metz, David C.

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N2 - OBJECTIVE: Previous studies have suggested that ineffective esophageal motility (IEM) may be a marker for gastroesophageal reflux disease (GERD), particularly supraesophageal reflux disease. We evaluated the relationship between esophageal acid exposure and esophageal body motility in patients undergoing both esophageal manometry and 24-h pH metry in the absence of antisecretory therapy. METHODS: We conducted a retrospective database review of 84 patients (mean age 47 yr, 46% male) evaluated in our GI physiology laboratory. The indication for testing was recorded and characterized as esophageal or supraesophageal. Abnormal esophageal acid exposure was defined as a distal esophageal pH <4 for more than 4.2% of the total monitoring time (>6.3% upright, >1.2% supine) or a proximal esophageal acid exposure time of greater than 1.1% total (>1.3% upright, 0% supine). IEM was defined as more than two of 10 ineffective peristaltic waves. RESULTS: Seventy-two patients had esophageal-presenting symptoms, and 12 had supraesophageal symptoms. The prevalence of abnormal esophageal acid exposure was similar in patients with esophageal and supraesophageal symptoms (69% vs 92%, p = 0.17). Abnormal motility was identified in 26 patients (31%). IEM was the most common motility disturbance (77%, 20 patients). The frequency of motility disorders was similar in patients with and without abnormal esophageal acid exposure (30% vs 35%, p = 0.79), in patients with esophageal or supraesophageal symptoms (32% vs 25%, p = 0.75, for all patients; 30% vs 27%, p = 1.00, for patients with abnormal esophageal acid exposure), and among upright, supine, and combined refluxers (33%, 9%, and 35%, p = 0.26). CONCLUSIONS: IEM does not stand alone as a significant marker for the presence of GERD in general or supraesophageal reflux disease in particular.

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