Loss of Esophageal Peristaltic Reserve Determined by Response to Multiple Rapid Swallows Utilizing High-Resolution Manometry in Patients with Eosinophilic Esophagitis

Manu, Kavya H.; Kunkel, David C.

doi:10.14309/00000434-201610001-00487

Cited by 1 publication

(2 citation statements)

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“…There were also a variety of abnormal manometric findings not fitting a particular Chicago 3 category reported in the EoE cohorts. We did not compute pooled estimates for these disorders, but they included “rapid” contractions, 7 “mild” IEM in 30%–40% ineffective swallows, 22 “abnormal” peristalsis, 20 “non‐specific esophageal motor disorder,” 6 “dynamic dysfunction” of the lower esophageal sphincter (LES), 25 and failure to augment peristalsis after multiple rapid swallows 34 . Three studies 21,24,33 noted that the most prevalent manometric abnormality in EoE subjects was early pan‐esophageal pressurization (seen in 10/21 subjects (48%), 17/48 (35%), and 7/20 (35%), respectively), but with relaxing LES.…”

Section: Resultsmentioning

confidence: 99%

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Association between eosinophilic esophagitis and esophageal dysmotility: A systematic review and meta‐analysis

Reddy

Ketchem

Dougherty

et al. 2022

Neurogastroenterology Motil

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Background: There is conflicting evidence about the association between eosinophilic esophagitis (EoE) and esophageal motility disorders. The aim of this study was to evaluate esophageal manometry findings in EoE. Methods:We conducted a systematic review using PubMed, EMBASE, and Web of Science. All articles from 1990 to 2021 with EoE patients who underwent esophageal manometry were eligible. We also included pertinent abstracts from national conferences from 2015 to 2020. The primary outcomes were the prevalence of specific Chicago 3 Classification (CCv3) diagnoses in EoE, as well as broader categories of non-relaxing lower esophageal sphincter, and major and minor peristaltic disorders.When multiple studies reported a specific outcome, we performed random effects meta-analysis to obtain pooled prevalence of each outcome. To reduce heterogeneity, we restricted meta-analysis to high-resolution manometry (HRM) studies only.Key Results: Of 763 publications identified, 27 original studies met criteria for inclusion, encompassing 706 EoE patients; 14 studies (425 patients) had HRM and underwent meta-analysis. The pooled prevalence of any motility abnormality was 53% (95% CI: 43%-63%), largely comprised of minor motility disorders such as ineffective esophageal motility and fragmented peristalsis. Major motility disorders, classified by CCv3, were less common in EoE, with pooled prevalence of 2% (0%-7%), 10% (5%-16%), and 1% (0%-3%), for achalasia, esophagogastric-junction outflow obstruction, and hypercontractile disorders, respectively. Conclusion and Inferences:Non-specific motility disorders were common in patients with EoE, but major motility disorders were rare. Further studies are needed to determine the relationship between eosinophilic infiltration and the clinical relevance of abnormal esophageal motility findings in this population.

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Section: Resultsmentioning

confidence: 99%

“…Through the initial database search, a total of 763 publications were identified, and after all stages of review (Figure 1) 27 original studies met criteria for inclusion, 6,7,18–42 representing a total of 706 patients with EoE. (Table 1) There was 18 retrospective studies and 9 prospective cohort studies.…”

Section: Resultsmentioning

confidence: 99%