The role of esophageal sphincter tonus and of gastric motility in the extent of reflux esophagitis

: Thirty-two patients with symptomatic gastroesophageal reflux disease were investigated by esophagogastroduodenoscopy, 24 h pH monitoring, esophageal manometry and measurement of gastric emptying of solids, in order to elucidate the relative importance of lower esophageal sphincter tone, amount of acid reflux and gastric emptying on the degree of esophagitis. The mechanical competency of lower esophageal sphincter was significantly deranged in patients with moderate/severe esophagitis than in patients with mild esophagitis. The gastric emptying time was significantly delayed in patients with moderate/severe esophagitis than in patients with mild esophagitis. No relationship was observed between amount of acid reflux, lower esophageal sphincter function and gastric emptying time. Our results suggest that resting pressure of lower esophageal sphincter and the gastric motor function play a major role in severity of reflux esophagitis.