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Macroscopic healing of esophagitis does not improve esophageal motility

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Abstract

The purpose of the present study was to prospectively determine if healing of esophagitis as assessed by endoscopy results in improved esophageal motility. Thirty-one patients with erosive esophagitis who were randomized to receive either omeprazole 20 mg once daily or placebo completed the double-blind study. All patients underwent endoscopy and esophageal motility before treatment and at four weeks after treatment. Twenty-two healthy volunteers underwent esophageal manometry and served as normal controls. Manometric tracings were coded, randomized, and analyzed blindly. Compared to normal controls, patients with esophagitis had significantly lower LESP, decreased amplitude of peristaltic contractions, and increased occurrence of abnormal contractions. Omeprazole was superior to placebo in healing of esophagitis. However, healing of esophagitis was not associated with any improvement in esophageal motility. The manometric data suggest that the motility disturbance seen in esophagitis is not secondary to the esophagitis but rather a primary phenomenon. The lack of improvement of esophageal motility with healing may explain the high recurrence of esophagitis in clinical trials following discontinuation of omeprazole.

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Authors and Affiliations

  1. From the Departments of Medicine and Pathology, Faculty of Medicine, University of Western Ontario, London, Ontario, Canada

    John M. Howard FRCP(C), Richard P. E. Reynolds FRCP(C), John V. Frei PhD, FRCP(C), Michele A. Flowers FRCP(C), T. J. McDonald FRCP(C), Kim Tilbe FRCP(C) & Donald C. Bondy FRCP(C)

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  1. John M. Howard FRCP(C)
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  2. Richard P. E. Reynolds FRCP(C)
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  3. John V. Frei PhD, FRCP(C)
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  4. Michele A. Flowers FRCP(C)
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  5. T. J. McDonald FRCP(C)
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  6. Kim Tilbe FRCP(C)
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  7. Donald C. Bondy FRCP(C)
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This work was supported by a grant from Astra Canada, Mississauga, Ontario, Canada.

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Howard, J.M., Reynolds, R.P.E., Frei, J.V. et al. Macroscopic healing of esophagitis does not improve esophageal motility. Digest Dis Sci 39, 648–654 (1994). https://doi.org/10.1007/BF02088355

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  • DOI: https://doi.org/10.1007/BF02088355

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