Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 7, 2011; 17(13): 1753-1758
Published online Apr 7, 2011. doi: 10.3748/wjg.v17.i13.1753
Gastroesophageal reflux in cirrhotic patients without esophageal varices
Jun Zhang, Pei-Lin Cui, Dong Lv, Shi-Wei Yao, You-Qing Xu, Zhao-Xu Yang
Jun Zhang, Pei-Lin Cui, Dong Lv, Shi-Wei Yao, You-Qing Xu, Zhao-Xu Yang, Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Zhang J and Cui PL contributed equally to this work; Zhang J and Cui PL designed this research and wrote the paper; Lv D and Yao SW collected clinical data; Xu YQ and Yang ZX worked as academic advisors of this research.
Correspondence to: Pei-Lin Cui, Associated Chief, Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. cuipl@yahoo.cn
Telephone: +86-10-67096644 Fax:+86-10-67096644
Received: January 4, 2011
Revised: February 21, 2011
Accepted: February 28, 2011
Published online: April 7, 2011
Abstract

AIM: To evaluate the esophageal motility and abnormal acid and bile reflux incidence in cirrhotic patients without esophageal varices (EV).

METHODS: Seventy-eight patients with liver cirrhosis without EV confirmed by upper gastroesophageal endoscopy and 30 healthy control volunteers were prospectively enrolled in this study. All the patients were evaluated using a modified protocol including Child-Pugh score, upper gastrointestinal endoscopy, esophageal manometry, simultaneous ambulatory 24-h esophageal pH and bilirubin monitoring. All the patients and volunteers accepted the manometric study.

RESULTS: In the liver cirrhosis group, lower esophageal sphincter pressure (LESP, 15.32 ± 2.91 mmHg), peristaltic amplitude (PA, 61.41 ± 10.52 mmHg), peristaltic duration (PD, 5.32 ± 1.22 s), and peristaltic velocity (PV, 5.22 ± 1.11 cm/s) were all significantly abnormal in comparison with those in the control group (P < 0.05), and LESP was negatively correlated with Child-Pugh score. The incidence of reflux esophagitis (RE) and pathologic reflux was 37.18% and 55.13%, respectively (vs control, P < 0.05). And the incidence of isolated abnormal acid reflux, bile reflux and mixed reflux was 12.82%, 14.10% and 28.21% in patients with liver cirrhosis without EV.

CONCLUSION: Cirrhotic patients without EV presented esophageal motor disorders and mixed acid and bile reflux was the main pattern; the cirrhosis itself was an important causative factor.

Keywords: Gastroesophageal reflux disease; Liver cirrhosis; Esophageal varices; Esophageal manometry; pH; Bilirubin; Monitoring