Hypertensive lower esophageal sphincter pressures and gastroesophageal reflux: an apparent paradox that is not unusual.

Abstract

The association of a hypertensive LESP and abnormal GER is not uncommon. When abnormal GER does occur in these patients, it tends to be mild but can be clinically important and respond to antireflux treatments. We recommend that patients with a hypertensive LESP and/or nutcracker esophagus who present with heartburn or chest pain should undergo ambulatory pH monitoring to evaluate the possibility of GER disease.