Relationship between severity of reflux esophagitis according to the Los Angeles classification and esophageal motility

Purpose. We investigated the relationship between the severity of reflux esophagitis (RE) according to the Los Angeles (LA) classification and esophageal motility. Methods. We examined 28 healthy subjects (HS) and 48 RE patients (grade A of the LA classification, 16 patients; grade B, 16 patients; grade C or D, 16 patients). Esophageal manometry was performed by the intraluminal microtransducer method. Resting lower esophageal sphincter (LES) pressure was assessed by the rapid pull-through method. Esophageal contraction after ten repeated 5-ml water swallowings separated by 30-s intervals was measured at 3, 8, 13, and 18 cm above the LES. Results. The resting LES pressure and the amplitude of esophageal contraction 3 cm above the LES in the grades C + D group were significantly lower than those in the HS group. The amplitude of esophageal contraction 3 cm above the LES in the grade B group was significantly lower than those in the grade A group and the HS group. The frequency of failed peristalsis in the grades C + D group was significantly higher than that in the HS group and the grade A and grade B groups. Conclusions. The present findings suggested that the severity of RE according to the LA classification would be likely to mainly reflect esophageal volume clearance. Received: June 28, 2000 / Accepted: December 1, 2000