The Effect of Anti-reflux Therapy on Patients Diagnosed with Minor Disorders of Peristalsis in High-resolution Manometry

Abstract

Background/Aims: Minor disorders of peristalsis are esophageal motility disorders categorized by the Chicago Classification (CC), version 3.0, which was announced in 2014. This study evaluated the efficacy of anti-reflux therapy in patients with minor peristaltic disorders. Methods: Patients with minor peristaltic disorders in accordance with CC v3.0 were included. We reviewed the medical records of patients with esophageal high-resolution manometry findings, and investigated the demographic and clinical information as well as the medical therapy. Thereafter, the response to treatment was assessed after at least 4 weeks of treatment. Results: A total of 24 patients were identified as having minor disorders of peristalsis from January 2010 to December 2015. The mean follow-up period was 497 days, and there were 17 patients (70.8%) patients with ineffective esophageal motility. In terms of anti-reflux therapy, proton pump inhibitors (PPIs) with prokinetic agents and PPIs alone were prescribed in 19 patients (79.2%) and 5 patients (20.8%), respectively. When the rate of response to the treatment was assessed, the responders rate (complete+sat-isfactory [≥50%] responses) was 54.2% and the non-responders rate (partial [<50%]+refractory responses) was 45.8%. Patients in the responder group were younger than those in the non-responder group (p=0.020). Among them, 13 patients underwent 24-hour multichannel intraluminal impedance-pH, and 10 patients (76.9%) were pathologic gastroesophageal reflux. Conclusions: The majority of esophageal minor peristaltic disorders were accompanied by gastroesophageal reflux, and therefore, they might respond to acid inhibitor. Further well-designed, prospective studies are necessary to confirm the effect of anti-reflux therapy in these patients. (Korean J Gastroenterol 2017;69:212-219)

Mosapride Improves Lower Esophageal Sphincter and Esophageal Body Function in Patients With Minor Disorders of Esophageal Peristalsis

“…An earlier study by our group reported a responder rate of 54.2% for minor peristaltic disorders in patients treated with anti- reflux therapy using PPIs or prokinetics. 23 Since the study was performed retrospectively, the results may vary from those in the current study. In addition, the results of this study are in close agreement with those in previous studies in patients with GERD.…”

Esophageal Motility Abnormalities in Lung Transplant Recipients With Esophageal Acid Reflux Are Different From Matched Controls

“…65 Furthermore, although our results suggest that hypoperistalsis is the main drive for GERD pathophysiology in the LT group, we are unable to ascertain a causative relation between peristaltic vigor and acid exposure due to the retrospective nature, a limitation that is common in studies of similar design. [66][67][68] In conclusion, this is the first study to our knowledge that compares the underlying manometric changes in LT recipients with pH proven acid reflux to matched controls. EGJ barrier function was less impaired with a higher TAPG in LT recipients.…”

“… 65 Furthermore, although our results suggest that hypoperistalsis is the main drive for GERD pathophysiology in the LT group, we are unable to ascertain a causative relation between peristaltic vigor and acid exposure due to the retrospective nature, a limitation that is common in studies of similar design. 66 - 68 …”