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Esophageal manometry findings and degree of acid exposure in short and long Barrett's esophagus

DOI: 10.1590/S0004-28032012000100011

Keywords: barrett esophagus, gastroesophageal reflux, manometry, esophageal motility disorders.

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Abstract:

context: barrett's esophagus (be) is characterized by intestinal metaplasia in the distal esophagus and is classified as short-segment (<3 cm - ssbe) or long-segment (>3 cm - lssbe). it is suggested that lssbe is associated with more severe esophageal motor abnormalities and increased acid exposure time than ssbe. objective: to evaluate the prevalence of esophageal manometriy abnormalities and acid exposure times in patients with ssbe and lssbe. methods: barrett's esophagus patients identified by upper endoscopy and confirmed by histopathology were, retrospectively, reviewed and divided into two groups: ssbe and lsbe. demographic data, symptom duration, prevalence of hiatal hernia, lower esophagus sphincter basal pressure, prevalence of esophageal body abnormalities and acid exposure times were evaluated. results: forty-six patients with ssbe (24 males - 52.2%, mean age of 55.2 years) and 28 patients with lsbe (18 males - 64.3%, mean age of 50.5 years). mean symptom duration was 9.9 years for ssbe and 12.9 years for lssbe. hiatal hernia was present in 84.2% of ssbe, 96.3% of lsbe; average lower esophagus sphincter pressure in ssbe 9.15 mm hg, in lsbe 6.99 mm hg; lower esophagus sphincter hypotension in ssbe was 65.9%, in lssbe 82.1%; aperistalsis in ssbe 6.5%, lssbe 3.6%; mild/moderate ineffective esophageal motility in ssbe 34.8%, lsbe 46.4%; severe moderate ineffective esophageal motility in ssbe 10.9%, lsbe 7,1%; nutcracker esophagus/segmental nutcracker esophagus in ssbe 8.6%, lsbe 0%; normal body in ssbe 39.1%, in lsbe 42.9%, no statistical difference for any of these values (p<0.05). average % total time ph<4 in ssbe 9.12, lsbe 17.27 (p<0.000); % time ph<4 upright in ssbe 11.91; lsbe 24.29 (p=0.003); % time ph<4 supine in ssbe 10.86, lsbe 33.26 (p = 0.000). conclusion: there was no difference between the prevalence of motor disorders in patients with ssbe and lssbe. acid reflux in upright and supine positions was more intense in lsbe.

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