Esophageal motility and 24-h pH profiles of patients with heterotopic gastric mucosa in the cervical esophagus

• DOI: 10.1016/j.ejim.2009.10.009
• Publication Date: 2009-11-28T09:29:21Z
• Authors: Esin Korkut; Mehmet Bektaş; Murat Alkan; Yusuf Üstün; Cem Meco; Ali Özden; Irfan Soykan
• Keywords: Adult; Male; 0301 basic medicine; Esophageal pH Monitoring; Manometry; Choristoma; Middle Aged; Esophageal Diseases; 3. Good health; Young Adult; 03 medical and health sciences; Esophagus; 0302 clinical medicine; Gastric Mucosa; Humans; Esophageal Motility Disorders; Female; Gastrointestinal Motility; Aged

Heterotopic gastric mucosa occurs as a flat island of red mucosa in the proximal third of the esophagus where it gives rise to the cervical inlet patch. The aims of this study were to investigate the esophageal motility pattern and 24-h pH profiles of patients with cervical inlet patch.Thirty patients (16 women, mean age: 44.9 years, range: 23-72) diagnosed as having heterotopic gastric mucosa in the cervical esophagus with upper gastrointestinal symptoms had undergone esophageal motility testing and 24-h pH monitorisation with a double-channel pH probe.Manometric investigation was abnormal in 7 patients (non-specific esophageal motor disorder in 4 patients, esophageal hypomotility in 1 patient, and hypotensive LES in 2 patients). Pathological acid reflux (pH<4) was found in 9 (30%) of 30 heterotopic gastric mucosa patients during pH monitorisation from the distal probe. Pathological acid reflux in the proximal esophagus (percentage of total time of pH<4) was seen in four of these nine patients. Only four of the 30 patients (13.3%) presented with "acid independent episodes" during the 24-h esophageal pH monitorisation.Manometric investigation and 24-h pH monitorisation revealed that some of the patients with HGM have signs of esophageal motor dysfunction and "acid independent episodes" from the patches. These abnormalities may be responsible for some of the symptoms of HGM patients.