Gastric emptying of solids in gastroesophageal reflux

Delayed gastric emptying has been assumed to play an important role in the pathogenesis of gastroesophageal reflux (GER), even though this relationship has not been definitely established. Eleven patients with symptomatic GER were studied by esophageal manometry, endoscopy, gastroesophageal scintiscanning and gastric emptying of a mixed meal. Nine healthy subjects served as controls. Gastric emptying of solids (evaluated both as emptying half-time and emptying index) in GER patients was significantly slower than in controls. In comparison with a "normal" range previously established in 50 healthy subjects, only 2 of 11 (18.2 p. 100) of GER patients had a normal emptying rate. In addition, a significant correlation was found between the emptying half-time and the degree of esophageal lesions. These results suggest that impaired motor function of the gastric antrum could influence the natural history of GER disease and especially the appearance of esophagitis. The lack of esophageal lesions in the only two patients with "normal" emptying strongly supports this hypothesis.