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Esophageal motility disorders account for a large proportion of nonobstructive dysphagia cases, which constitute a heterogeneous group of diagnoses that commonly result in peristaltic derangement and impaired relaxation of the lower esophageal sphincter. We performed a single-institution retrospective study enrolling consecutive patients with chief complaints of dysphagia who underwent HRIM from December 2014 to December 2019, and analyzed demographic, clinical, and manometric data using descriptive statistics. In total, 277 identified patients were included in the final analysis. Ineffective esophageal motility ( = 152, 24.5%) was the most common diagnosis by HRIM, followed by absent contractility, EGJ outflow obstruction, type II achalasia, and type I achalasia. Furthermore, surgery including exploratory, laparoscopic, and robotic myotomy, as well as POEM, is considered the most effective treatment for patients with non-spastic achalasia and EGJOO, due to its effective symptom palliation and prevention of disease progression; surgery also contributes to an obvious improvement of dysphagia compared with slightly less efficacy for other related symptoms. Our study aimed to elaborate the clinical characteristics of patients with nonobstructive dysphagia based on HRIM in a Taiwanese population, and to analyze the therapeutic outcomes of such patients who ultimately underwent surgical interventions.
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http://dx.doi.org/10.3390/jpm12040590 | DOI Listing |
Therap Adv Gastroenterol
June 2025
Endoscopy and Gastrointestinal Motility Unit, ManopH, Oporto, Portugal.
Background: Nonobstructive esophageal dysphagia (NOD) is a common benign condition that significantly impacts quality of life. Management requires a motility-focused approach and consideration for concomitant comorbidities such as gastroesophageal reflux, visceral hypersensitivity, and psychological factors. Currently, esophagogastric junction (EGJ) outflow disorders have the most studied and effective treatments.
View Article and Find Full Text PDFNeurogastroenterol Motil
September 2025
Department of Internal Medicine, Israelitic Hospital Hamburg, Academic Hospital University of Hamburg, Hamburg, Germany.
Background: In patients with non-cardiac chest pain (NCCP) and non-obstructive dysphagia (NOD), standard esophageal high resolution manometry (HRM) with water swallows and/or solid meals may miss intermittent dysmotility. To what extent prolonged 24 h-measurements may increase the diagnostic sensitivity is currently unclear.
Methods: 75 patients (47 female, 58 ± 16 years) with NCCP and/or NOD underwent standard HRM (single water swallows plus rice meal) and ambulatory 24-h-HRM with impedance.
Am J Gastroenterol
January 2025
Neurogastroenterology and Motility Unit, Gastroenterology Department, Institut Clínic de Malalties Digestives i Metabòliques (ICMDM), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
Introduction: The causal relationship between chronic opioid use and esophageal motor dysfunction in symptomatic patients has not been established.
Methods: A prospective before-and-after multicenter study, including chronic active opioid patients referred for esophageal motility tests because of nonobstructive dysphagia.
Results: Thirty-seven patients were evaluated, and 27 (73%) had criteria for opioid-induced esophageal dysfunction.
Clin Gastroenterol Hepatol
December 2024
Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology; Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Age-related changes in esophageal function involve increased rates of dysmotility with advancing age (sometimes described as presbyesophagus). Specifically, advanced age has been associated with increased lower esophageal sphincter (LES) pressure and decreased peristaltic vigor. However, the mechanisms underlying these changes, including the relative relationship of primary peristalsis and secondary peristalsis over the lifespan, remain incompletely understood.
View Article and Find Full Text PDFJ Can Assoc Gastroenterol
June 2024
Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada.
Background: The extent of disease severity remains unclear among CYP2C19 rapid and ultra-rapid metabolizers with refractory symptoms of gastroesophageal reflux disease (GERD) on chronic proton-pump inhibitors (PPIs).
Aims: To determine the impact of CYP2C19 metabolizer status in relation to chronic PPI therapy with a focus on the extent of esophageal inflammation, acid exposure, and motor function.
Methods: This retrospective study included 54 patients with refractory GERD symptoms who underwent genotyping for PPI metabolism, esophagogastroduodenoscopy, ambulatory pH study, and high-resolution esophageal manometry.