Is ineffective esophageal motility associated with gastropharyngeal reflux disease?

Table 1 Patient profiles and the endoscopic findings in the patients with normal esophageal motility and ineffective esophageal motility n (%)

	Normal (n = 264)	IEM (n = 195)	P value
Age (yr, mean ± SD)	50.8 ± 11.1	51.1 ± 12.0	0.782
Gender (men/women)	99/165	87/108	0.125
BMI (kg/m2, mean ± SD)	23.6 ± 2.7	23.2 ± 2.7	0.393
Alcohol intake	58 (22.0)	31 (15.9)	0.104
Smoking	43 (16.3)	19 (9.7)	0.043
Heartburn/acid regurgitation1	128 (48.5)	104 (53.3)	0.304
Indication for pH monitoring			0.542
Globus	118 (44.7)	88 (45.1)
Hoarseness	63 (23.9)	35 (17.9)
Cough	27 (10.2)	24 (12.3)
Sore throat	30 (11.4)	28 (14.4)
Others2	26 (9.8)	20 (10.3)
Reflux esophagitis3	30 (11.4)	30 (15.4)	0.206
A	22	16
B	7	11
C	1	2
D	0	1
Hiatal hernia	17 (6.4)	10 (5.1)	0.555
Endoscopically suspected esophageal metaplasia	23 (8.7)	11 (5.6)	0.214

¹More than 2 d per wk;

²Other indications were halitosis, throat clearing and laryngeal pathology such as vocal polyp;

³Los Angeles classification grade. IEM: Ineffective esophageal motility.

Table 2 Results of the lower esophageal sphincter and ambulatory 24-h dual probe pH monitoring in the patients with normal esophageal motility and ineffective esophageal motility

	Normal (n = 264)	IEM (n = 195)	P value
Lower esophageal sphincter
Pressure	21.4 ± 0.5	18.6 ± 0.5	< 0.001
Length	3.3 ± 0.1	3.3 ± 0.1	0.921
Proximal probe
Time pH < 4 (total) (%)	0.4 ± 0.1	0.7 ± 0.2	0.225
Time pH < 4 (upright) (%)	0.7 ± 0.1	1.0 ± 0.2	0.230
Time pH < 4 (supine) (%)	0.1 ± 0.0	0.6 ± 0.4	0.214
No. of reflux episodes	8.7 ± 1.0	12.2 ± 2.6	0.219
Distal probe
Time pH < 4 (total) (%)	2.9 ± 0.2	3.5 ± 0.3	0.185
Time pH < 4 (upright) (%)	4.8 ± 0.7	5.0 ± 0.5	0.827
Time pH < 4 (supine) (%)	1.6 ± 0.3	1.9 ± 0.4	0.564
No. of reflux episodes	44.1 ± 2.5	47.8 ± 4.0	0.430
No. of reflux episodes ≥ 5 min	1.4 ± 0.2	1.9 ± 0.3	0.116
Longest reflux episode (min)	8.6 ± 0.8	10.2 ± 1.0	0.199
DeMeester composite score	12.1 ± 0.9	14.1 ± 1.3	0.217

IEM: Ineffective esophageal motility.

Table 3 Distribution of the patients with gastroesophageal reflux disease and/or gastropharyngeal reflux disease, as defined by ambulatory pH monitoring, in the patients with normal esophageal motility and ineffective esophageal motility n (%)

	Normal (n = 264)	IEM (n = 195)
GERD and GPRD	108 (40.9)	74 (37.9)
GPRD only	56 (21.2)	33 (16.9)
GERD only	19 (7.2)	18 (9.2)
Normal	81 (30.7)	70 (35.9)

GERD: Gastroesophageal reflux disease; GPRD: Gastropharyngeal reflux disease; IEM: Ineffective esophageal motility.