Does healing of esophagitis improve esophageal motor function?

Area of Science:

• Gastroenterology
• Esophageal Physiology
• Surgical Gastroenterology

Background:

• Erosive esophagitis is associated with esophageal motor abnormalities.
• The impact of healing on these abnormalities is not well understood.

Purpose of the Study:

• To investigate if healing of erosive esophagitis improves esophageal motor function.
• To compare the effects of surgical versus medical treatment on esophageal motility and relapse rates.

Main Methods:

• Esophageal manometry was performed in 18 patients with erosive esophagitis before and after healing.
• Patients received either Nissen fundoplication or H2-receptor antagonists.
• A control group of 15 healthy individuals was included.
• Long-term follow-up (mean 3.0 years) assessed symptoms and relapse.

Main Results:

• Patients with erosive esophagitis had lower contraction amplitudes and lower esophageal sphincter pressures than controls.
• Healing of esophagitis did not alter esophageal contraction amplitude, duration, or velocity.
• Surgical treatment increased lower esophageal sphincter pressure; medical treatment did not.
• All surgically treated patients remained asymptomatic, while 8/9 medically treated patients relapsed.

Conclusions:

• Healing of erosive esophagitis does not restore normal esophageal motor function.
• Surgical intervention, unlike medical management, improves esophageal motor function and prevents relapse.
• Impaired esophageal motility post-healing may contribute to relapse in medically treated patients.