Healing of Severe Esophagitis Improves Esophageal Peristaltic Dysfunction

Reflux esophagitis is frequently associated withperistaltic dysfunction, which increases with theseverity of inflammatory lesions. In order to assessperistaltic dysfunction with more accuracy before and after healing, we used a 24-hr pH andpressure recording method. Nineteen patients (medianage: 65, range: 33-77) with stage II and III(Savary-Miller classification) esophagitis andperistaltic dysfunction were treated with 40 mg omeprazole for three tosix months until complete endoscopic healing wasachieved. Before treatment, median contraction amplitudewas significantly lower than median contraction amplitude of a control group of comparable age[31 (21-53) versus 42 (21-77) mm Hg, P < 0.01], aswell as median percentage of peristaltic contractions[27 (16-63) versus 44 (11-56), P < 0.01]. At the end of treatment, a statisticallysignificant improvement of esophageal motor functionswas observed for both median contraction amplitude [38(26-55), P = 0.001] and median percentage of peristaltic waves [45 (23-68), P = 0.0001]. Theposttreatment values, although still low, were notsignificantly different from control values. Inconclusion, complete healing of grade II and IIIesophagitis improves peristalsis. Inflammatory processes related tosevere esophagitis may be involved in failed peristalsisand low contraction amplitude.