Eosinophilic esophagitis: manometric and pHmetric findings

Abstract

-Context -Eosinophilic esophagitis is an entity characterized by an esophageal inflammatory infiltrate of eosinophils, manifested by dysphagia, intermittent food impactions and symptoms similar to gastroesophageal reflux disease (GERD), that predominantly affects young adults. There may be association of eosinophilic esophagitis with GERD, and motor abnormalities have been described. Objective -The main objectives of this study are to describe the findings at esophageal manometry and pH monitoring in patients with eosinophilic esophagitis. Methods -Cross-sectional study of 20 patients with a diagnosis of eosinophilic esophagitis, submitted to esophageal manometry and 24h pH monitoring. Were analysed the manometric changes and the presence of abnormal reflux on pH monitoring. Results -Twenty patients (15 men, 5 women) had a mean age of 29 years. Motility disorders were found in 25% (5/20) patients with ineffective esophageal motility being the most common finding. pH monitoring revealed abnormal reflux on 25%, without any relationship with manometric findings. Conclusions -Manometric abnormalities were observed in 25% of patients and abnormal reflux on pH monitoring also in 25%. This study showed no relationship between abnormal reflux and the presence of manometric changes.

Intrabolus pressure on high-resolution manometry distinguishes fibrostenotic and inflammatory phenotypes of eosinophilic esophagitis

“…Several studies have been published investigating esophageal dysmotility in patients with EoE. Many of these early investigations revealed variable motility patterns, but were significantly limited by the use of conventional manometry . High‐resolution manometry (HRM), a diagnostic tool that has its origins in convention manometry tracings, has become the investigative study of choice in the evaluation of esophageal motility disorders.…”

Prevalence of esophageal motility abnormalities increases with longer disease duration in adult patients with eosinophilic esophagitis

“…Esophageal motility is evaluated using manometry . Conventional and high‐resolution manometric studies have demonstrated a variety of motility disorders, which were present in 0–90% of EoE patients . The observed motility patterns are not specific for EoE, and range from absent peristalsis to achalasia, diffuse esophageal spasm, nutcracker esophagus, panesophageal pressurization, and ineffective peristalsis (Table S1).…”

Cellular and molecular immunological mechanisms in eosinophilic esophagitis: an updated overview of their clinical implications

“…In fact, rather than exhibiting an increase in eosinophils, the smooth muscle of EoE patients presents an increase in mast cell numbers, with the TGF-b1 expressed by them possibly increasing the contractility of smooth muscle fibers [86], thereby modulating esophageal contractility. Hypertrophy of the muscularis mucosa along with the circular and longitudinal muscle layers has also been reported in patients with EoE [161], contributing to the esophageal dysfunction repeatedly demonstrated in pediatric [162] and adult EoE patients [163][164][165]. Finally, eosinophilic infiltration of the submucosal and myenteric neuronal plexus has also been documented in EoE [144].…”