A study on the esophageal dynamics in patients with gastroesophageal reflux disease and with refractory cough undergoing esophageal high-resolution manometry

Objective: To analyze the esophageal dynamics in patients with gastroesophageal reflux disease (GERD) and with refractory cough while undergoing esophageal high-resolution manometry (HRM). Methods: A total of 32 patients with GERD and with refractory cough and 48 patients with GERD admitted to our hospital from February 2019 to July 2020 were assigned to the combined group and the GERD group, respectively, and 40 healthy volunteers were assigned to the healthy group. All the patients underwent HRM. The lower esophageal sphincter (LES) and the upper esophageal sphincter (UES) parameters, the types of peristalsis of the esophageal body, the esophageal body motility, the i relaxation of LES and UES incidence rates, and the esophageal body motility disorders were compared among the three groups. Results: The combined group and the GERD group had lower esophageal sphincter pressure (LESP) levels and lower 4-s integrated relaxation pressure (4 s IRP) levels, shorter lower esophageal sphincter lengths (LESL), and higher frequencies and longer durations of transient lower esophageal sphincter relaxation (TLESR) compared with the healthy group (P < 0.05). The upper esophageal sphincter lengths (UESL) in the GERD group were longer than they were in the healthy group (P < 0.05). Compared with the healthy group and the GERD group, the combined group had longer distal latencies (DL), break distances, and peristaltic breaks (PB), longer large and small peristaltic breaks, a greater number of ineffective swallows, lower upper esophageal sphincter pressure (UESP) levels, distal contraction integrals (DCI), contractile front velocities (CFV), and a higher incidence rate of esophageal body motility disorders (P < 0.05). Conclusion: Patients with GERD and with refractory cough often also have esophageal body motility disorders, longer PB, elevated UESP levels, and lower DCI. HRM can be used to objectively evaluate the esophageal dynamics and to differentiate among diseases.