Dysphagia Worsens With Increasing Ineffective Swallows Among Patients With Ineffective Esophageal Motility.
J Clin Gastroenterol
; 57(7): 694-699, 2023 08 01.
Article
em En
| MEDLINE
| ID: mdl-35960530
ABSTRACT
INTRODUCTION:
Ineffective esophageal motility (IEM) is the most common motility disorder identified on esophageal high-resolution manometry (HRM), but patients with this finding may be asymptomatic. Therefore, we aimed to identify specific HRM findings predictive of symptoms in IEM.METHODS:
Adult patients (≥18 y) who underwent HRM between March 2016 and July 2019 were retrospectively evaluated and reclassified according to Chicago Classification 4.0 (CC4.0). Demographic information, HRM parameters, and gastroesophageal reflux disease Health-Related Quality of Life Questionnaire responses were captured among those with normal manometry or IEM. We evaluated the association between heartburn, regurgitation, and dysphagia, with respect to HRM findings including ineffective swallows.RESULTS:
Of 379 patients, 243 (64.1%) had a normal manometry, 136 (35.9%) were on IEM spectrum, and 73 (19.3%) had conclusive IEM by CC4.0. Mean dysphagia scores were significantly higher in those with conclusive IEM compared with those with normal HRM (2.00 vs. 1.36, P =0.002), as was the percentage of individuals reporting dysphagia affecting daily activities (21.9% vs. 11.4%, P =0.02). Heartburn and regurgitation symptoms did not differ between groups. In a multivariable model of IEM patients, the percentage of ineffective swallows independently predicted a higher dysphagia burden (ß regression coefficient 0.032, P =0.04).CONCLUSIONS:
Applying the CC4.0 definition for conclusive IEM identifies a group of patients with worse dysphagia symptoms. Within this group, the percentage of ineffective swallows was an independent predictor of dysphagia severity. These findings may help practitioners and patients contextualize the heterogeneous diagnosis of IEM.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos da Motilidade Esofágica
/
Transtornos de Deglutição
/
Andorinhas
Tipo de estudo:
Prognostic_studies
Aspecto:
Patient_preference
Limite:
Adult
/
Animals
/
Humans
Idioma:
En
Revista:
J Clin Gastroenterol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Marrocos