550 Conventional Esophageal Manometry Findings and Current Criteria of Ineffective Esophageal Motility Poorly Correlate with Reflux Clearance and Proximal Spread of Gastro-Esophageal Reflux in NERD Patients

Background: Gastro-esophageal reflux disease (GERD) has a prevalence of 10-20% in the Western countries while its prevalence amongst the Pakistani population is between 22 to 24%. Esophageal manometry is currently the gold standard for diagnosing esophageal motility disorders. Aims and Objectives: To determine the frequency of esophageal motility disorder in patients with GERD. Materials and Methods: This cross-sectional study was conducted at the department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan. Patients diagnosed with GERD (defined as having typical reflux symptoms with more than 2 episodes per were) were included in this study. These patients were subjected to upper GI endoscopy followed by esophageal manometry. Esophageal motility disorders were then classificated by using the Chicago classification 3.0. Results: A total of 76 patients were included in our study, out of which 41 (53.9%) were females. A mean age of 46.1 years ± 12 years and a mean body mass index (BMI) of 23.7kg/m2 was noted. The most common comorbid condition seen in our patients was diabetes mellitus, which was seen in 13 patients (17%). A normal EGD was noted in 48 patients (63%). Liquid perfusion esophageal manometer catheter was mainly used in our study that is in 70 patients (92.1%). Weak esophageal peristalsis was the most common esophageal motor abnormality seen in 16 patients (21.1%). Conclusion: A significant proportion of patients with GERD have the presence of a motility disorders, the early identification and treatment of which can lead to improvement GERD symptoms.

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The Effect of Diet Composition Change on High-Resolution Oesophageal Manometry Metrics in Non-Erosive Gastroesophageal Reflux Disease Patients

Current Developments in Nutrition ◽

10.1093/cdn/nzaa040_054 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 54-54

Author(s):

Sergey Morozov ◽

Vasily Isakov

Keyword(s):

High Resolution ◽

Esophageal Motility ◽

Esophageal Manometry ◽

Diet Composition ◽

Control Group ◽

Study Group ◽

Ineffective Esophageal Motility ◽

Dietary Fiber Intake ◽

Significant Difference ◽

Resting Pressure

Abstract Objectives To evaluate the influence of change of diet composition on esophageal manometry metrics. Methods The data of 43 NERD patients with low (<20 g/day) baseline dietary fiber intake served as a source data. These patients were examined with the use of standard food frequency questionnaire and high-resolution esophageal manometry. Thirty of them received psyllium 5.0 g TID 10 days in addition of their usual diet within registered clinical trial (NCT01882088). The other 13 were found in the database by diagnosis; their data were eligible in case of the presence of repeated high-resolution esophageal manometry examination and dietary assessments at the same time point and if no significant change in diet composition was revealed. The changes were assessed in accordance to Chicago classification 3.0. Non-parametric statistics (Wilcoxon matched pairs test, Mann-Whitney U-test) were used to assess the change in HRM metrics in these groups. Results In those who received psyllium, significant increase of minimal lower esophageal resting pressure at rest and after 10 water swallows was registered: 5.41 ± 10.1 vs 11.3 ± 9.4 mm Hg, P = 0.023 and 14.1 ± 8.0 vs 14.9 ± 6.4 mm Hg, P = 0.008, accordingly. No significant difference was found in the group with no change of diet composition by these parameters. At baseline, ineffective esophageal motility was found in 46.7% patients of the study group and 53.8% in the control group (P = 0.7). Esophageal motility became normal in 71.4% of those who had IEM initially in the study group after 10 days of treatment, and in 14.3% among the controls (P = 0.0135). This type of peristaltic abnormality was found not changed in 28.6% of the study group and in 85.7% among the control group, P = 0.014. New cases of ineffective esophageal motility revealed in 12.5% of the study group and 16.7% among the controls (P = 0.8) Conclusions Change of diet composition by additional quantity of psyllium may result in the improvement of esophageal motility. Funding Sources Federal Research Center of Nutrition and Biotechnology.

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Tu1280 – Performing More Than Ten Swallows During High Resolution Esophageal Manometry Does Not Identify Substantially More Cases of Ineffective Esophageal Motility

Gastroenterology ◽

10.1016/s0016-5085(19)39490-9 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-1016

Author(s):

Xiaocen Zhang ◽

Elijah Verheyen ◽

Jean Abed ◽

Xiaowen Fan ◽

Michael S. Smith ◽

...

Keyword(s):

High Resolution ◽

Esophageal Motility ◽

Esophageal Manometry ◽

Ineffective Esophageal Motility

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Measurement of Lower Esophageal Sphincter (LES) Characteristics during Esophageal Manometry Does Not Differ with Severity of Ineffective Esophageal Motility

The American Journal of Gastroenterology ◽

10.14309/00000434-200709002-00012 ◽

2007 ◽

Vol 102 ◽

pp. S122-S123

Author(s):

Vishal Jain ◽

Neeraj Sharma ◽

Marcelo Vela ◽

Donald Castell

Keyword(s):

Lower Esophageal Sphincter ◽

Esophageal Motility ◽

Esophageal Manometry ◽

Ineffective Esophageal Motility ◽

Esophageal Sphincter

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ENDOSCOPIC EVALUATION OF MANOMETRIC PROFILE OF GASTRO ESOPHAGEAL REFLUX DISEASE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i7.436 ◽

2019 ◽

Vol 3 (7) ◽

Author(s):

Dr. Radhey Shyam Gupta

Keyword(s):

Lower Esophageal Sphincter ◽

Reflux Disease ◽

Esophageal Motility ◽

Study Participant ◽

Lower Esophageal Sphincter Pressure ◽

P Value ◽

Sphincter Pressure ◽

Esophageal Reflux ◽

Ineffective Esophageal Motility ◽

Esophageal Sphincter

Background: Gastro esophageal reflux disease leads to poor quality of life to patients because of pain and discomfort. Some studies also reported that incidence of adenocarcinoma of esophagus and Barrett's esophagus among patients with reflux disease. The abnormal esophageal motility act as a major risk factors and also reported with severity and prognosis of the disease. Material & Methods: In present study 50 patients of heart burn or acid regurgitation (GERD) for at least more than 3 months were enrolled from outdoor and from ward by simple random sampling. Clearance from Institutional Ethics Committee was taken before start of study. Written informed consent was taken from each study participant. Results: 15 (30%) had non-erosive reflux disease and 35 (70%) had erosive reflux disease. Among the patients of non-erosive reflux disease, 13 (26%) had normal lower esophageal sphincter pressure and 2 (4%) had Low Lower esophageal sphincter pressure. Among the patients of erosive reflux disease, 32 (64%) had normal lower esophageal sphincter pressure and 3 (6%) had Low Lower esophageal sphincter pressure (P value >0.05). Among the patients of non-erosive reflux disease, 10 (20%) had normal esophageal motility and 5 (10%) had Ineffective esophageal motility. Among the patients of erosive reflux disease, 25 (50%) had normal esophageal motility and 10 (20%) had Ineffective esophageal motility (P value >0.05). Conclusion: Low Lower esophageal sphincter and Ineffective or abnormal esophageal motility pressure was non-significantly associated with non-erosive and erosive reflux disease. Ineffective esophageal motility and Low LES pressure was the main cause for gastro esophageal reflux disease Keywords: GERD, High Resolution Manometry, Ineffective peristalsis.

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The Relevance of Ineffective Esophageal Motility to Surgical Practice

Foregut: The Journal of the American Foregut Society ◽

10.1177/26345161211044102 ◽

2021 ◽

Vol 1 (3) ◽

pp. 250-253

Author(s):

Geoffrey P. Kohn

Keyword(s):

Esophageal Motility ◽

Esophageal Manometry ◽

Esophagogastric Junction ◽

Postoperative Dysphagia ◽

Treatment Protocols ◽

Surgical Practice ◽

Ineffective Esophageal Motility ◽

Foregut Surgery ◽

Provocation Testing ◽

Dysphagia Outcomes

Foregut surgery is often complicated by postoperative dysphagia. Preoperative esophageal manometry has been used to counsel patients and to guide choice of operation to minimize dysphagia outcomes. Uncertainty surrounds the optimal surgical management of patients with disordered motility. While treatment protocols are generally accepted for the disorders of esophagogastric junction outflow, surgery choice in the presence of disorders of peristalsis, particularly ineffective esophageal motility (IEM), is less clear. With the diagnosis of IEM, provocation testing is being utilized to predict postoperative dysphagia and to guide management, though evidence is not yet sufficient to allow for strong recommendations.

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Rheumatologic disorders in patients undergoing esophageal manometry: prevalence, symptom characteristics, and manometric findings

Diseases of the Esophagus ◽

10.1093/dote/doaa135 ◽

2021 ◽

Author(s):

Anam Qureshi ◽

Asad Jehangir ◽

Zubair Malik ◽

Henry P Parkman

Keyword(s):

Lupus Erythematosus ◽

Esophageal Motility ◽

Esophageal Manometry ◽

Upper Esophageal Sphincter ◽

Motility Disorders ◽

Ineffective Esophageal Motility ◽

Upper Gi ◽

Gi Symptoms ◽

Esophageal Sphincter ◽

Esophageal Contractility

Summary Rheumatologic disorders (RDs) can have gastrointestinal (GI) manifestations. Systemic sclerosis (SSc) patients often have upper GI symptoms from absent esophageal contractility (AC). Upper GI symptom characteristics and high-resolution esophageal manometry with impedance (HREMI) findings of other RDs have not been well studied. We aimed to: (i) determine the prevalence of RD in patients undergoing HREMI and (ii) assess the symptom characteristics and manometric findings of these patients. Patients undergoing HREMI (July 2018 to March 2020) rated their GI symptoms’ severity. Healthy volunteers (HVs) also underwent HREMI. Of the 1,003 patients, 90 (9%) had RD (mean age: 55.3 ± 1.4 years, 73.3% females), most commonly SSc (n = 27), rheumatoid arthritis (RA, n = 20), and systemic lupus erythematosus (SLE, n = 11). The most severe upper GI symptoms in patients with RD were heartburn, regurgitation, nausea, and dysphagia, with no significant differences in their severities between SSc, RA, and SLE. RD patients had higher upper esophageal sphincter (UES) pressures, lower distal contractile integral (DCI), lower bolus clearance, and more frequent hiatal hernia (HH) on HREMI (all P < 0.05) than HVs. Over half (61.1%) of patients with RD had esophageal motility disorders, most commonly AC (n = 25), ineffective esophageal motility (IEM; n = 18), and esophagogastric junction (EGJ) obstructive disorders (n = 11). Among patients undergoing HREMI, 9% had RD. Upper GI symptom severities did not distinguish different RDs. Patients with RD had higher UES pressures, weaker DCI, lower bolus clearance, and more frequent HH than HVs. Although AC and IEM were most common motility disorders, a considerable minority (12.2%) of our RD patients had EGJ obstructive disorders.

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