Abstract
The aim of this study was to define the difference of pathophysiology between complicated reflux esophagitis, such as, Barrett's epithelium and esophageal stricture (13 cases) and uncomplicated reflux esophagitis (7 cases). Moreover, we try to set up rational approach for complicated reflux esophagitis by esophageal manometric study, and 24-hour intraesophageal pH monitoring. The gastroesophageal reflux was defined as a fall in intraesophageal pH below 4.0, and semiquantitation of regurgitated acid was obtained by weighing the area of the ref lux. Obtained result showed no significant difference of LESP between complicatied and uncomplicated cases (p>0.10). However, semi-quantitated acid regurgitation showed that complicated cases had significantly increased acid regurgitation than that of uncomplicated cases indicating 24 -hour pH monitoring (p<0.01) reflected the pathophysiology of reflux esophgitis better than measuring LESP. Furthermore, the 24-hour pH monitoring was useful to define the adequate dosage of the Cimetidine to control acid reflux in patient with complicated reflux esophagitis. With such adequate dosage of H2-blocker, we could obtained excellent therapeutic effects including symptomatic relief, healing of ulcer and resolving or regression of Barrett's epithelium in almost all the patients.
