Patients with nonerosive reflux disease have the lowest esophageal acid exposure profile compared with the other gastroesophageal reflux disease (GERD) groups.
Dr Ronnie Fass and colleagues from Arizona determined the characteristics of esophageal acid exposure along the esophagus among the different GERD groups.
The research team compared lower esophageal acid exposure recordings 1 cm above and 6 cm below the lower esophageal sphincter.
The team enrolled 64 patients with classic heartburn symptoms into the study.
Patients were evaluated by a demographics questionnaire and the validated GERD Symptom Checklist.
|Acid exposure occured 1 cm above the lower esophageal sphincter|
|American Journal of Gastroenterology|
Upper endoscopy was performed to evaluate the presence of esophageal erosions and Barrett's esophagus.
The team performed ambulatory pH testing using a commercially available 4-sensor pH probe with sensors located 5 cm apart.
The researchers placed the distal sensor 1 cm above the lower esophageal sphincter.
The team noted that 21 patients had nonerosive reflux disease, 20 had erosive esophagitis, and 23 had Barrett's Esophagus.
The researchers demonstrated that all patient groups had greater esophageal acid exposure at 1 cm above the lower esophageal sphincter than 6 cm above.
In nonerosive reflux disease and erosive esophagitis, the similarity was due to a higher mean percentage of upright time with a pH less than 4.
Unlike patients with erosive esophagitis and Barrett's, those with nonerosive reflux disease had little variation in acid exposure throughout the esophagus.
Dr Fass's team concludes, “All GERD groups demonstrated significant greater esophageal acid exposure at the very distal portion of the esophagus, primarily as a result of short upright reflux events.”
“Unlike erosive esophagitis and Barrett's Esophagitis, nonerosive reflux disease patients demonstrate a more homogenous acid distribution along the esophagus.”