Screening of Minor Disorders of Peristalsis of Esophagus in Iranian Patients with Nonerosive Reflux Disease (NERD) Based on 24-Hour Multichannel Intraluminal Impedance-pH (MII-PH) Monitoring Tests

Abstract

Background/Aims: Impedance associated with PH monitoring is a new technique that can be used to detect acidic, weakly acidic, and nonacidic reflux episodes. Also, this technique can be used to recognize fluids and gas. The present study was conducted to evaluate the differences in the total number of reflux episodes and its composition in participants with nonerosive reflux disease (NERD) and minor disorders of peristalsis of esophagus and NERD based on the new technique of combined multichannel intraluminal impedance-pH(MII-PH) monitoring in Iranian population.
Method: This study was conducted on 1134 participants aged 18 to70 years with NERD. They were selected using a questionnaire and esophagogastroduodenoscopy findings. MII-pH monitoring test was performed for all the patients. The number of reflux episodes and its composition, DeMeester score, integrated relaxation pressure 4(IRP4), and distal contractile integral (DCI) were recorded.
Results: Of the 325 participants in the ineffective esophageal motility group, 66.7% showed a pathological acid exposure of time (EAET), which was more than the normal peristalsis group (43.6%).The frequency of upright and supine position of acid reflux was both 51.1% in ineffective esophageal motility (IEM) participants, whereas the frequency of upright and supine position of acid reflux in patients with normal peristalsis was 24.8% and 23.1%, respectively. Weakly acid reflux was more prevalent in NERD participants with IEM than participants with normal peristalsis.
Conclusion: The present study revealed that acid, weakly acid, and gas reflux were more prevalent in NERD participants with minor disorders of peristalsis of esophagus than in patients with normal peristalsis. Mean integrated relaxation pressure4 (IRP4) and distal contractile integral (DCI) were significantly lower in those with minor disorders of peristalsis of esophagus than in those with normal peristalsis.