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Lower esophageal sphincter pressures in gastroesophageal reflux disease: Where do they stand?

Madhu Bhatt, Bikalp Thapa.

Abstract
Background: Esophageal manometry is mandatory for localization of lower esophageal sphincter (LES) in patients undergoing ambulatory esophageal pH-metry for proper positioning of the pH-sensing catheter. Manometry not only gives the location of LES but also provides its tone in terms of basal lower esophageal sphincter pressure (BLESP) in mm Hg.

Aims and Objectives: To study the LES pressures in cases of gastroesophageal reflux disease and to evaluate its significance by determining correlation between LES pressures and DeMeester score.

Materials and Methods: In the study, 54 subjects with clinical diagnosis of gastroesophageal reflux participated. Manometry was performed using pneumohydraulic water perfused system, followed by a 24-h ambulatory esophageal pH-metry. The data were subjected to statistical analysis using SPSS software, version 22.

Results: The mean BLESP was 13.68 ± 3.93 mm Hg, and DeMeester score was 16.94 ± 9.57. A significant negative correlation with a Pearson’s correlation coefficient (r) of -0.632 (p < 0.001) was seen between BLESP and DeMeester score.

Conclusion: High DeMeester score as in cases of gastroesophageal reflux is found to be significantly negatively correlated with low values of BLESP.

Key words: Basal Lower Esophageal Sphincter Pressure; Esophageal pH-metry; DeMeester Score; Gastroesophageal Reflux; Correlation



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