Reflux patterns and related oesophageal motor activity in gastro-oesophageal reflux disease

Simultaneous intraoesophageal pH and pressure monitoring were performed for 12 hours in 20 patients with abnormal acid gastrooesophageal reflux or oesophagitis and in 10 healthy volunteers to determine characteristic reflux patterns with time. Increased acid exposure was not the only factor that characterised patients with oesophagitis. Indeed an overlap existed between patients with and without oesophagitis regarding total acid exposure time. Patients with oesophagitis suffered reflux nearly as much at night and in the morning as during the postprandial period. They also had as much reflux as a result of small and slow changes in pH around the pH limit of 4 as they had due to proper reflux episodes. This did not change over time after the postprandial period. More 12 hour acid exposure was related to more frequent night time reflux. In normal subjects compared with patients reflux triggered increased contractile activity, and contractile activity at a normal pH was greater in patients than in normal subjects.