Abstract
Abstract Background The aim of the study was to evaluate, if gastroesophageal reflux disease (GERD), esophageal motility disorders and gastrointestinal symptoms are influenced by the levels of hormones. Methods One-hundred patients with symptoms of GERD were included in the study. All patients routinely underwent 24-hours esophageal impedance pH-monitoring (MII-pH) and high-resolution esophageal manometry (HRM). Symptoms were evaluated using the Reflux-symptom index (RSI) and symptom check list (SCL) questionnaire. Blood samples were taken to analyze the levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), gastrin, vasoactive intestinal peptide (VIP) and calcitonin. According to the results of HRM, patients were subdivided into three motility disorder groups: patients with EGJ (esophageal gastric junction) outflow obstruction or major motility disorders (group I), patients with minor motility disorders (group II) and patients with normal esophageal motility (group III). According to the results of 24h-pH-impedence-monitoring patients were divided in patients with and without objective GERD. Results Complete data was available from 86/100 patients (44 men, 42 women with a median age of 56 years). Motility disorders were found in 38/86 patients (22 in group I, 16 in group II). A pathological DeMeester score was found in 45/86 patients (median score 35). No correlation between different hormone levels and DeMeester score, LES-pressure and patients with motility disorders (group I, II) was found. A significant difference regarding calcitonin level was found between group I and III (P = 0043). Furthermore a strong inverse relation between calcitonin and the Integrated Relaxation Pressure (IRP) was found (r = -0492; P = 0000). Positive correlations were found between VIP and GI-Symptoms (r = 0298; P = 0011), as well as correlations between FT3 and dysphagia (r = 0283, P = 0016). Conclusion Calcitonin could have an effect on the function of the EGJ and esophageal motility. The hormones TSH, FT3, FT4, VIP and gastrin do not affect the motility of the esophagus and the EGJ. The levels of the evaluated hormones do not influence distal acid exposure. Thyroid hormones, as well as VIP seem to influence gastrointestinal symptoms. Disclosure All authors have declared no conflicts of interest.
Published Version
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