Heterogeneity of Esophageal Motor Abnormalities in Scleroderma Patients Assessed With High Resolution Esophageal Pressure Topography

Vela, Marcelo F.; Crowell, Michael D.; Umar, Sarah B.; Griffing, Leroy W.; Garcia, Heidi; DiBaise, John K.

doi:10.14309/00000434-201510001-01678

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“…We found four studies reporting the specific prevalence of JE in morbidly obese patients or patients undergoing evaluation for bariatric surgery, 34‐37 six in patients with systemic sclerosis 38‐43 and four in postlung transplant patients 44‐47 (Figure 3). When compared to the prevalence of JE in the unselected general symptomatic population referred for HRM, diagnoses of JE were significantly more frequent in morbidly obese patients (5.18% [95% CI: 1.76%‐14.3%]; P = .009) and in postlung transplant patients undergoing HRM (23.99% [95% CI: 9.00%‐38.97%]; P < .001).…”

Section: Resultsmentioning

confidence: 99%

“…We found four studies reporting the specific prevalence of JE in morbidly obese patients or patients undergoing evaluation for bariatric surgery, [34][35][36][37] six in patients with systemic sclerosis [38][39][40][41][42][43] and four in postlung transplant patients [44][45][46][47] (Figure 3 of whether or not they were symptomatic. We found Kristo et al 34 to be an influential study and once excluded the prevalence of JE in obese patients was no longer statistically superior to the unselected general population (Table S2).…”

Section: Prevalence In Specific Populationsmentioning

confidence: 99%

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Jackhammer esophagus: A meta‐analysis of patient demographics, disease presentation, high‐resolution manometry data, and treatment outcomes

Wahba

Bouin

2020

Neurogastroenterology Motil

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Background: Jackhammer esophagus (JE) is a newly described esophageal motility disorder. However, there are limited data on JE and this entity remains misunderstood. Methods: We performed a systematic review of clinical series on JE through MEDLINE, EMBASE, and Web of Science. Data from included studies were then extracted, and random-effects meta-analyses were performed. Results: Thirty-eight studies met inclusion criteria. The pooled prevalence of JE was 1.97% [95% CI: 1.39%-2.78%] among patients referred for high-resolution manometry (HRM). The mean age at diagnosis was 60.8 years [95% CI: 57.1-64.4] and 65% [95% CI: 58%-72%] of patients were female. JE was significantly more prevalent in postlung transplant patients and morbidly obese patients undergoing HRM (23.99% [95% CI: 9.00%-38.97%] and 5.18% [95% CI: 1.76%-14.3%] respectively). Dysphagia was the most common presentation of JE (64% [95% CI: 52%-77%]) followed by gastroesophageal reflux disease (46% [95% CI: 26%-67%]). The pooled mean distal contractile integral (DCI) of all standard HRM swallows was 9249 mm Hg•s•cm [95% CI: 7834-10 663], and the pooled mean integrated relaxation pressure (IRP) was 13.9 mm Hg [95% CI: 8.2-19.7]. Overall, 73.6% [95% CI: 64.0%-83.1%] of JE patients who underwent treatment achieved clinical symptom improvement (79% [95% CI: 74%-85%] for endoscopic treatment and 63% [95% CI: 47%-79%] for medical treatment). The pooled clinical success rate of peroral endoscopic myotomy (POEM) specifically was 82% [95% CI: 75%-90%]. Conclusions: JE is a new motility disorder most commonly presenting with dysphagia. High clinical suspicion is important because the diagnosis can only be made through HRM.

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Section: Resultsmentioning

confidence: 99%