Revised Criterion for Diagnosis of Ineffective Esophageal Motility Is Associated With More Frequent Dysphagia and Greater Bolus Transit Abnormalities

Abstract

Our study indicates that IEM with > or = 50% ineffective liquid swallows is frequently associated with bolus transit abnormalities and esophageal symptoms. Our results underscore the rationale for using the new definition of IEM.

Esophageal Body Motility for Clinical Assessment in Patients with Refractory Gastroesophageal Reflux Symptoms

“…impaired bolus transit and esophageal clearance, 16,37 which could partly explain the above results. But how reflux occurs is a complex process, which is an imbalance between the ability of anti-reflux and reflux, and RGERD is more complicated than normal GERD.…”

“…However, the severity of esophageal mucosal damage is the result of balancing between reflux materials and esophageal anti-reflux, and increased gastroesophageal reflux could lead to a reduction in esophageal compliance and an increased resistance during bolus movement with a consequent delayed bolus transport. IEM could be partly related to esophageal mucosal injury based on that IEM was associated with impaired bolus transit and esophageal clearance; 16,37 moreover, it could be more complicated in RGERD patients. Long term usage of PPIs is unlikely to improve the RGERD patients' symptoms, but it could reduce esophageal inflammation and lead to negative endoscopy findings.…”

“…[15][16][17] High-resolution manometry (HRM) is a more user-friendly and accurate technology than conventional manometry. This technique allows for a dynamic representation of the pressure pattern throughout the entire esophagus.…”

The Relationship Between Dysphagia, Pump Function, and Lower Esophageal Sphincter Pressures on High-Resolution Manometry

“…Patients with previous foregut surgery (55), achalasia (17), large hiatus hernia (>5 cm), or stricture (15) were excluded leaving 113 patients, who form the cohort for this study (Fig. 3).…”

Esophagus: Functional/Motility Abnormalities

“…Ineffective esophageal motility is defined by 30% of distal contractions <30 mmHg and/or 30% of contractions that are not transmitted or aperistaltic (Blonski et al 2008). This disorder was first described as nonspecific esophageal motility disorders and is very common in GERD patients with respiratory symptoms, and is also common in patients with GERD esophagitis and Barrett's.…”