Abstract
Background
An association between eosinophilic esophagitis (EoE) and esophageal motility disorders has been described in small studies.
Aims
The aim of this study was to describe the prevalence of esophageal motor disorders in a large cohort of adults with EoE and examine whether an association exists between esophageal dysmotility and dysphagia.
Methods
A retrospective review of esophageal manometry studies in adult EoE patients was performed. Tracings were reviewed for abnormalities including nutcracker esophagus and ineffective swallows, defined as low amplitude peristalsis (<30 mmHg) or non-propagating contractions. Ineffective esophageal motility (IEM) was categorized as mild (30–40% ineffective swallows), moderate (50–60% ineffective swallows), and severe (≥70% ineffective swallows). Dysphagia was graded on a 0–3 scale for frequency and severity.
Results
Seventy-five tracings from EoE patients were reviewed (85% male, mean age 41 ± 12 years). IEM was identified in 25 patients and categorized as mild (n = 13), moderate (n = 6), and severe (n = 6). Nutcracker esophagus was found in three patients. There was no significant difference in eosinophil count among the motility groups: normal 46.5 ± 3.1, mild IEM 56.9 ± 36.9, moderate IEM 45.5 ± 23.7, severe IEM 34.3 ± 12.6 (P = 0.157).
Conclusions
In this cohort of EoE patients, the majority had normal esophageal motility studies, although a subset of these patients had some esophageal dysmotility. It is unlikely that esophageal dysmotility is a major contributing factor to dysphagia, although it is reasonable to consider esophageal manometry testing in EoE patients to identify potential abnormalities of the smooth muscle esophagus.
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The opinions are solely those of the authors and do not represent an endorsement by the Department of Defense. There are no restrictions on its use. The authors do not have any commercial or proprietary interest in any drug, device, or equipment mentioned in the manuscript. There are no conflicts of interest, financial disclosures, grant support or writing assistance.
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Moawad, F.J., Maydonovitch, C.L., Veerappan, G.R. et al. Esophageal Motor Disorders in Adults with Eosinophilic Esophagitis. Dig Dis Sci 56, 1427–1431 (2011). https://doi.org/10.1007/s10620-011-1655-5
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DOI: https://doi.org/10.1007/s10620-011-1655-5