Unit of Gastroenterology and Digestive Endoscopy, Campus Bio Medico University , Rome, Italy.
Expert Rev Gastroenterol Hepatol. 2020 Oct;14(10):933-940. doi: 10.1080/17474124.2020.1791703. Epub 2020 Jul 13.
The management of gastro-esophageal reflux disease (GERD) patients is often complex as the clinical presentation is heterogeneous and the mechanisms underlying symptoms are multifactorial. In the past decades, investigations conducted with conventional manometry and, above all, the more accurate high resolution manometry (HRM), helped us in exploring the field of esophageal motility and in understanding the link between motor features and GERD pathogenesis.
Several studies carried out with conventional manometry and HRM have confirmed a relevant role of esophageal motor function in GERD pathogenesis. In particular, HRM studies have shown a direct correlation between impaired esophageal body motility, disruption of the esophagogastric junction and reflux burden. These findings impact the clinical and therapeutical management of GERD patients. Moreover, HRM findings might be helpful in evaluating patients with proton pump inhibitor (PPI) resistance and inconclusive evidences of GERD.
The relationship between esophageal motility and GERD pathogenesis needs to be further evaluated by multicenter outcome studies involving a large number of GERD patients and healthy controls. However, other more promising areas could be progressed.
胃食管反流病（GERD）患者的治疗通常较为复杂，因为临床表现具有异质性，而症状的发生机制是多因素的。在过去的几十年中，采用传统测压法和（尤其是）更为精确的高分辨率测压法（HRM）进行的研究帮助我们深入探索食管动力领域，并了解了运动特征与 GERD 发病机制之间的联系。
多项采用传统测压法和 HRM 进行的研究证实了食管运动功能在 GERD 发病机制中的重要作用。特别是，HRM 研究表明，食管体运动障碍、食管胃连接部功能障碍和反流负担之间存在直接相关性。这些发现影响了 GERD 患者的临床和治疗管理。此外，HRM 结果可能有助于评估质子泵抑制剂（PPI）抵抗和 GERD 证据不明确的患者。
食管动力与 GERD 发病机制之间的关系需要通过涉及大量 GERD 患者和健康对照者的多中心结局研究进一步评估。然而，其他更有前途的领域可能会取得进展。
