Original Articles: Oesophageal DisordersHeterogeneity in oesophageal dysfunction among patients with different reflux symptomsChen, Chien-Lin; Yi, Chih-Hsun; Liu, Tso-Tsai Author Information Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan Correspondence to Chien-Lin Chen, MD, PhD, Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, 707, Section 3, Chung-Yang Road, Hualien, Taiwan Tel: +886 385 61825; fax: +886 385 77161; e-mail: [email protected] Received March 6, 2012 Accepted April 30, 2012 European Journal of Gastroenterology & Hepatology: September 2012 - Volume 24 - Issue 9 - p 1059-1065 doi: 10.1097/MEG.0b013e3283556311 Buy Metrics Abstract Background and aim Ineffective oesophageal motility (IOM) often occurs in patients with gastro-oesophageal reflux disease. We aimed to examine the hypothesis of whether the presence of IOM differs between patients with gastro-oesophageal reflux disease with different symptom profiles. Methods Eligible patients were subclassified according to their predominant symptom of heartburn (HB) or acid regurgitation (AR). All patients underwent combined multichannel intraluminal impedance and oesophageal manometry. IOM was further graded according to the presence of oesophageal transit abnormalities. Results Fourteen healthy individuals, 16 HB patients and 24 AR patients participated in this study. The percentage of swallows with complete bolus transit was lower in AR than in HB patients during liquid and viscous swallowing (P<0.05). Abnormal bolus transit occurred more frequently in AR patients than in HB patients with liquid swallows (P<0.001) and viscous swallows (P<0.05). IOM occurred more frequently in AR patients than in HB patients (42.7 vs. 12.5%, P=0.049). In patients with IOM, severe functional abnormality was more frequently found in AR patients than in HB patients (P<0.05). Conclusion This study suggests a potential link between oesophageal body dysfunction and individual reflux symptom. Patients with a predominant symptom of AR are characterized by greater IOM and defective bolus clearance. © 2012 Lippincott Williams & Wilkins, Inc.