[Esophageal peristalsis and acid clearance. A study method]

Peristaltic waves account for clearance of acid refluxed into the oesophagus, acting as a second anti-reflux barrier. We have developed a system combining oesophageal motor and pH studies. We use a three-lumen, constantly perfused, manometry probe attached to a pH microelectrode. Primary and secondary oesophageal waves are able to clear injected acid from the oesophagus, whilst non-propulsive tertiary waves do not raise pH back to normal levels. Children with severe GER have a high proportion of tertiary waves, and it is tempting to incriminate these motor disturbances as an important for their bad tolerance to GER.