Does healing of esophagitis improve esophageal motor function?

Abstract

This study investigates whether healing of erosive esophagitis leads to an improvement of esophageal motor abnormalities. Manometric studies were performed in 18 patients with erosive esophagitis before and after healing of the mucosal lesions and in 15 healthy controls. Nine patients were treated with a Nissen fundoplication and nine with H2-receptor antagonists. After healing, patients were followed for a mean duration of 3.0 +/- 0.4 years. Compared to controls, patients had significantly lower contraction amplitudes and lower esophageal sphincter pressures (P less than 0.01), while the duration and velocity of esophageal contractions was similar in both groups. Lower esophageal sphincter pressure increased after surgical treatment, while no such changes were observed in medically treated patients. In both groups amplitude, duration, and velocity of esophageal contractions were not affected by healing of esophagitis. On extended follow-up, all surgically treated patients remained asymptomatic while eight of nine medically treated patients developed a symptomatic relapse which was accompanied by erosive esophagitis in six of them. The lack of improvement in esophageal motor function after healing of esophagitis may contribute to the frequent occurrence of relapse in medically treated patients.