Esophageal Motility in Gastroesophageal Reflux Disease
The correlation between gastroesophageal reflux disease (GERD) and motility disorders of the esophagus is still a matter of discussion (Table 1). Bumm  reports on a chronologic relation between motility events and reflux episodes in the esophagus in healthy volunteers. He found that GER episodes mainly influence frequency and type rather than amplitude and duration of contractions. Other investigators demonstrate that an increasing degree of esophagitis leads to a decrease in contraction amplitude and to an increase in pathologic contractions , as well as to an accumulation of defective primary peristalsis or hypertensive peristalsis in the distal esophagus . A clear trend as to the correlation of the two pathophysiologic findings, esophagitis and esophageal motility disorder, cannot be derived from these reports. Two other studies investigating esophageal motility before and after healing of esophagitis by omeprazol come to exactly opposite conclusions: on the one hand an improvement in peristaltic force and clearance could be demonstrated, leading to the conclusion that motility disorders are caused by an inflammatory dysfunction of the plexus myentericus . On the other hand, a significant difference could not be demonstrated comparing contraction amplitudes before and after healing of esophagitis, leading to the conclusion that motility disorders are a primary phenomenon and not the result of mucosal damage .
KeywordsMotility Disorder Gastroesophageal Reflux Disease Mucosal Damage Esophageal Motility Reflux Episode
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