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Disturbances of Esophageal Motility in Eosinophilic Esophagitis: A Case Series

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Abstract

Esophageal manometry (EM) findings were reviewed in 14 (13 male) adults diagnosed with eosinophilic esophagitis (EE). One had complete nonperistaltic contractions (amplitude range = 30–180 mmHg) and incomplete relaxation of the lower esophageal sphincter (LES), suggesting vigorous achalasia. After 6 months of steroid therapy the repeat EM showed near-normal findings. One had total aperistalsis with contraction amplitudes less than 10 mmHg and a weak LES pressure (8 mmHg), criteria suggesting scleroderma. Two had low-amplitude (<30 mmHg) nonperistaltic contractions limited to the mid-esophagus. Criteria for nutcracker esophagus were met in two patients. Isolated low LES pressure (<15 mmHg) was observed in four patients who were also receiving proton pump inhibitors, and the remainder had normal EM findings. Our results found that EE can mimic all the categories of EM disturbances, with approximately 50% of our patients having a major impairment of smooth muscle function. The EM abnormality can be reversed to normal in some cases with appropriate treatment for EE.

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Acknowledgments

The authors thank the faculty, fellows, and staff of the Division of Gastroenterology for their clinical involvement with the study’s patients, and the pathology faculty for reviewing the slides.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Kansas University Medical Center, 3901 Rainbow Blvd., MS-1058, Kansas City, KS, 66160-7350, USA

    Reza A. Hejazi, Savio C. Reddymasu, Sandra Sostarich & Richard W. McCallum

  2. Department of Internal Medicine, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, 4800 Alberta Avenue, El Paso, TX, 79905, USA

    Richard W. McCallum

Authors
  1. Reza A. Hejazi
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  2. Savio C. Reddymasu
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  3. Sandra Sostarich
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  4. Richard W. McCallum
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Correspondence to Richard W. McCallum.

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Hejazi, R.A., Reddymasu, S.C., Sostarich, S. et al. Disturbances of Esophageal Motility in Eosinophilic Esophagitis: A Case Series. Dysphagia 25, 231–237 (2010). https://doi.org/10.1007/s00455-009-9248-6

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  • DOI: https://doi.org/10.1007/s00455-009-9248-6

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