Heterotopic gastric mucosa in the cervical oesophagus ?inlet patch?: clinic, manometric, and ph metric characteristics

Background: Heterotopic gastric mucosa (HGM) in proximal oesophagus is yellowish-pink mucosal islands separated from normal mucosa with a sharp border.Aim: To determine clinical characteristics, oesophageal motor functions and pH profiles of the patients with HGM and to evaluate the possible effect of HGM on these entities.Material and Methods: Thirty patients with HGM were included in this study. Patients were divided in to 2 groups according to the reflux symptom scoring: reflux positive and reflux negative. Oesophagus manometry and 24-h double- channel pH metry were performed to all patients.Results: Eighteen (60%) and 12 (%40) patients were reflux positive and negative, respectly. According to the reflux symptom scoring, symptoms in HGM patients were as follows: dysphagia (30%), globus sensation (40%), regurgitation (60%), chronic cough (26%), hoarseness (10%), halitosis (40%), throat clearing (53%), sore throat >6 month (20%), snore (40%), glossodynia (16%), nocturnal apne (0%), morning hoarseness (33%). Statistical significance was found in HGM cases with reflux symptom about dysphagia (%44.4 vs. %8.3; p=0.04), sore throat (%33.3 vs. 0; p=0.031) and morning hoarseness (%50 vs. %8.3; p=0.021). Acid reflux findings were determined with distal pH metry in 4 patients. In 3 of these cases showed abnormal proximal acid reflux. None of these reflux episodes were in the form of isolated proximal reflux. None of the patients showed oesophageal motor dysfunction.Conclusion: In general HGM can be presented as supraesophageal symptoms of gastroesophageal reflux disease. Low acid secretion of HGM had no contributor effect on reflux symptoms. We believe that HGM in oesophagus is a benign lesion having no distribution effect on oesophagus motor function and acid reflux parameters.Key words: Heterotopic gastric mucosa, gastroesophageal reflux, pH-monitoring, oesophagus manometry