비특이성 식도운동장애 환자에서 위식도 역류 질환의 유병률

초록

Backgroud/Aims: The nonspecific esophageal motility disorder (NEMD) has been reported to be related to gastroesophageal reflux disease (GERD) in some cases. However, the pathophysiologic mechanism of NEMD has not been estabilished. The aim of this study was to assess the prevalence of esophagitis and gastric acid reflux following abnormal contractions in patients with NEMD. Methods: 122 NEMD patients were enrolled (76 male and 46 female) and their endoscopic findings and 24 hour esophageal Ph data were compared with 24 healthy subj ects. The abnormal contractions were classified as 1) non-transmitted con-traction, 2) low amplitude contraction, 3) non-transmitted and low amplitude contraction, and 4) others. Results: Among the 122 patients with NEMD, 62 patients (50.8%) had GERD, 53 patients (43.4%) had endoscopic reflux esophagitis, and 41patients (33.6%) had both. Acid exposed time studied by 24 hour Ph monitoring was more increased in NEMD patients than in healthy controls (7.48± 10.68 vs 1.42 ± 1.17), but there were no differences among abnormal contraction patterns. Moderate to severe reflux esophagitis were frequently seen in patients with combined abnormal contractions as the results of endoscopic findings. Pre-existing factors for the gastric acid reflux in NEMD patients were male and esophageal hiatal hernia. Conclusions: Large numbers of NEMD patients were found to have concurrent GERD in our study. However, the esophageal peristaltic dysfunction was more closely related to the severity of esophagitis rather than to the amount of refluexed gastric acid itself.

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