Barrett's oesophagus: pH profile.

Twenty-four patients with a columnar-lined (Barrett's) oesophagus underwent oesophageal manometry and 24 h ambulatory oesophageal pH monitoring. The results were compared with 25 patients with oesophagitis studied in the same fashion. No significant difference in lower oesophageal sphincter pressure was demonstrated between the two groups. The Barrett's patients demonstrated significantly greater acid exposure in the distal oesophagus than oesophagitis patients. Clearance or refluxed acid was poorer in Barrett's patients than oesophagitis patients. Twelve of the Barrett's patients presented with complications of the condition, i.e. ulceration or stricture. No significant difference in acid exposure was demonstrated between Barrett's patients with or without complications. These results suggest that patients with columnar-lined (Barrett's) oesophagus have greater acid exposure than patients with oesophagitis. The development of complications of a Barrett's oesophagus may not be dependent on acid reflux alone.