Distal Esophageal Hypercontractility Is Related to Abnormal Acid Exposure

Julio César Soto-Pérez, Sergio Sobrino-Cossío, Paul B. Higgins, Anthony G. Comuzzie, Jose Antonio Vargas Romero, Arturo Reding-Bernal, Juan Carlos López-Alvarenga

Research output: Contribution to journalArticle

Abstract

Background and Aims: Nutcracker esophagus (NE) is a frequent primary motility disorder of the distal esophagus, and the relationship with acid exposure remains controversial. We studied simultaneous distal esophageal hypercontractility (EH) using two sensors at 8 and 3 cm above the lower sphincter (LES) and abnormal exposure to acid (pH DeMeester score). Methods: From 400 screened patients with chest pain and heartburn, 54 (age 44.5 ± 8.8 years and 74% females) had abnormal manometry and underwent acid exposure measurement. Frequencies of the EH disorder were classic NE (EH3 cm) found in 29 (40.8%) patients, diffuse (EH3,8 cm) in 30 patients (42.3%), and upper segmental (EH8 cm) in 12 patients (16.9%). Results: We found a positive correlation among age with high amplitude in EH3 cm and EH3,8 cm. DeMeester's score (DMS) had the lowest value for EH3,8 cm (2.58 ± 0.23) compared with EH8 cm (3.78 ± 0.3, p <0.003) and EH3 cm (3.12 ± 0.2, p <0.06). Surface response for joint effect of age and DMS on amplitude at EH3 cm confirmed the highest amplitude was for older age and lower DMS. Conclusions: EH3 cm and EH3,8 cm were common for esophageal motility and were inversely associated with DMS. Meanwhile, acid exposure was higher in younger patients and hypercontractility was more frequent in older subjects. The former group may benefit more from proton pump inhibitors and the latter from visceral analgesics or possibly both.

Original languageEnglish (US)
Pages (from-to)104-109
Number of pages6
JournalArchives of Medical Research
Volume42
Issue number2
DOIs
StatePublished - Feb 2011
Externally publishedYes

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Acids
Esophageal Motility Disorders
Heartburn
Proton Pump Inhibitors
Manometry
Chest Pain
Esophagus
Analgesics

Keywords

  • Chest pain
  • Esophageal motility disorders
  • Lower esophageal sphincter
  • Manometry
  • Upper esophageal sphincter

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Soto-Pérez, J. C., Sobrino-Cossío, S., Higgins, P. B., Comuzzie, A. G., Vargas Romero, J. A., Reding-Bernal, A., & López-Alvarenga, J. C. (2011). Distal Esophageal Hypercontractility Is Related to Abnormal Acid Exposure. Archives of Medical Research, 42(2), 104-109. https://doi.org/10.1016/j.arcmed.2011.02.003

Distal Esophageal Hypercontractility Is Related to Abnormal Acid Exposure. / Soto-Pérez, Julio César; Sobrino-Cossío, Sergio; Higgins, Paul B.; Comuzzie, Anthony G.; Vargas Romero, Jose Antonio; Reding-Bernal, Arturo; López-Alvarenga, Juan Carlos.

In: Archives of Medical Research, Vol. 42, No. 2, 02.2011, p. 104-109.

Research output: Contribution to journalArticle

Soto-Pérez, JC, Sobrino-Cossío, S, Higgins, PB, Comuzzie, AG, Vargas Romero, JA, Reding-Bernal, A & López-Alvarenga, JC 2011, 'Distal Esophageal Hypercontractility Is Related to Abnormal Acid Exposure', Archives of Medical Research, vol. 42, no. 2, pp. 104-109. https://doi.org/10.1016/j.arcmed.2011.02.003
Soto-Pérez JC, Sobrino-Cossío S, Higgins PB, Comuzzie AG, Vargas Romero JA, Reding-Bernal A et al. Distal Esophageal Hypercontractility Is Related to Abnormal Acid Exposure. Archives of Medical Research. 2011 Feb;42(2):104-109. https://doi.org/10.1016/j.arcmed.2011.02.003
Soto-Pérez, Julio César ; Sobrino-Cossío, Sergio ; Higgins, Paul B. ; Comuzzie, Anthony G. ; Vargas Romero, Jose Antonio ; Reding-Bernal, Arturo ; López-Alvarenga, Juan Carlos. / Distal Esophageal Hypercontractility Is Related to Abnormal Acid Exposure. In: Archives of Medical Research. 2011 ; Vol. 42, No. 2. pp. 104-109.
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abstract = "Background and Aims: Nutcracker esophagus (NE) is a frequent primary motility disorder of the distal esophagus, and the relationship with acid exposure remains controversial. We studied simultaneous distal esophageal hypercontractility (EH) using two sensors at 8 and 3 cm above the lower sphincter (LES) and abnormal exposure to acid (pH DeMeester score). Methods: From 400 screened patients with chest pain and heartburn, 54 (age 44.5 ± 8.8 years and 74{\%} females) had abnormal manometry and underwent acid exposure measurement. Frequencies of the EH disorder were classic NE (EH3 cm) found in 29 (40.8{\%}) patients, diffuse (EH3,8 cm) in 30 patients (42.3{\%}), and upper segmental (EH8 cm) in 12 patients (16.9{\%}). Results: We found a positive correlation among age with high amplitude in EH3 cm and EH3,8 cm. DeMeester's score (DMS) had the lowest value for EH3,8 cm (2.58 ± 0.23) compared with EH8 cm (3.78 ± 0.3, p <0.003) and EH3 cm (3.12 ± 0.2, p <0.06). Surface response for joint effect of age and DMS on amplitude at EH3 cm confirmed the highest amplitude was for older age and lower DMS. Conclusions: EH3 cm and EH3,8 cm were common for esophageal motility and were inversely associated with DMS. Meanwhile, acid exposure was higher in younger patients and hypercontractility was more frequent in older subjects. The former group may benefit more from proton pump inhibitors and the latter from visceral analgesics or possibly both.",
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