Characteristics of Consecutive Esophageal Motility Diagnoses After a Decade of Change

Abstract

Background and Aims: Combined multichannel intraluminal impedance and esophageal manometry (MII-EM) measures concomitantly bolus transit and pressure changes allowing determination of the functional impact of esophageal motility abnormalities. Ten years ago our laboratory reported MII-EM results in 350 consecutive patients. Since then high-resolution impedance manometry (HRIM) became available and the definitions of ineffective esophageal motility (IEM) and nutcracker esophagus were revised. The aim of this study was to assess the impact of these developments on esophageal function testing.

Ineffective esophageal motility: Concepts, future directions, and conclusions from the Stanford 2018 symposium

“…The widespread use of high‐resolution manometry (HRM) has led to increasing recognition of esophageal motor dysfunction . Currently designated a minor esophageal motility disorder, ineffective esophageal motility (IEM) is reported in as many as 30% of patients undergoing HRM with unclear clinical implications and management. An international group of esophageal motor physiologists, clinicians, endoscopists, and surgeons who are international thought leaders in esophageal physiology and pathophysiology met at Stanford, CA, in July 2018 for a one‐day symposium to discuss the pathophysiologic basis and clinical implications of IEM.…”

Alteraciones motoras menores del esófago según manometría de alta resolución: ¿qué significan?

“…Con el uso de la MAR se ha registrado MEI en 20 a 38% de los pacientes con síntomas esofágicos 7,9,15 . Se la ha descrito en relación con múltiples trastornos (Tabla 2).…”

“…Los trastornos motores menores son los hallazgos más comunes en las series de pacientes 6,7 . Con la CC v. 2.0, Ravi, et al demostraron un 26.6% 8 .…”

Severity of ineffective esophageal motility is associated with utilization of skeletal muscle relaxant medications

“…First incorporated into the classification of esophageal motor disorders in 2001 (and defined by conventional manometry as at least 50% of swallows with amplitude less than 30 mm Hg), it is estimated to have a prevalence ranging from 20% to 50% in those with symptoms of dysphagia. 1,2 In addition, it has also been associated with advanced gastro-esophageal reflux disease and extra-esophageal manifestations of Gastroesophageal reflux diseases (GERD). Ineffective esophageal motility may have a wide variety of clinical presentations, disease courses and manometry findings.…”

“…Ineffective esophageal motility (IEM) is a common condition in patients with symptoms of dysphagia. First incorporated into the classification of esophageal motor disorders in 2001 (and defined by conventional manometry as at least 50% of swallows with amplitude less than 30 mm Hg), it is estimated to have a prevalence ranging from 20% to 50% in those with symptoms of dysphagia . In addition, it has also been associated with advanced gastro‐esophageal reflux disease and extra‐esophageal manifestations of Gastroesophageal reflux diseases (GERD).…”