Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
Eur J Gastroenterol Hepatol. 2012 Sep;24(9):1059-65. doi: 10.1097/MEG.0b013e3283556311.
Ineffective oesophageal motility (IOM) often occurs in patients with gastro-oesophageal reflux disease. We aimed to examine the hypothesis of whether the presence of IOM differs between patients with gastro-oesophageal reflux disease with different symptom profiles.
Eligible patients were subclassified according to their predominant symptom of heartburn (HB) or acid regurgitation (AR). All patients underwent combined multichannel intraluminal impedance and oesophageal manometry. IOM was further graded according to the presence of oesophageal transit abnormalities.
Fourteen healthy individuals, 16 HB patients and 24 AR patients participated in this study. The percentage of swallows with complete bolus transit was lower in AR than in HB patients during liquid and viscous swallowing (P<0.05). Abnormal bolus transit occurred more frequently in AR patients than in HB patients with liquid swallows (P<0.001) and viscous swallows (P<0.05). IOM occurred more frequently in AR patients than in HB patients (42.7 vs. 12.5%, P=0.049). In patients with IOM, severe functional abnormality was more frequently found in AR patients than in HB patients (P<0.05).
This study suggests a potential link between oesophageal body dysfunction and individual reflux symptom. Patients with a predominant symptom of AR are characterized by greater IOM and defective bolus clearance.
胃食管反流病患者常存在食管运动功能障碍（IOM）。本研究旨在检验食管运动功能障碍在不同症状为主的胃食管反流病患者间是否存在差异的假说。
将符合条件的患者根据烧心（HB）或反酸（AR）的主要症状进行亚组分类。所有患者均接受多通道腔内阻抗和食管测压联合检查。根据食管通过异常的存在进一步对 IOM 进行分级。
本研究共纳入 14 名健康个体、16 名 HB 患者和 24 名 AR 患者。在液体和粘性吞咽时，AR 患者的完全吞咽通过的吞咽比例低于 HB 患者（P<0.05）。与 HB 患者相比，AR 患者在液体吞咽（P<0.001）和粘性吞咽（P<0.05）时异常通过的吞咽更频繁。与 HB 患者相比，AR 患者中 IOM 更常见（42.7%比 12.5%，P=0.049）。在存在 IOM 的患者中，与 HB 患者相比，AR 患者更常出现严重的功能异常（P<0.05）。
本研究提示食管体功能障碍与个体反流症状之间可能存在关联。以 AR 为主要症状的患者表现出更大的 IOM 和缺陷性的食团清除能力。
