Exploratory Research on Latent Esophageal Motility Disorders in Dysphagia Patients

Kawaguchi, Shinpei; Takeuchi, Toshihisa; Inoue, Yousuke; Takahashi, Yoshiaki; Ozaki, Haruhiko; K, Ota; Harada, Satoshi; Edogawa, Shoko; Kojima, Yuichi; Yamashita, Hiroshi; Fukuchi, Takumi; Ashida, Kiyoshi; Higuchi, Kazuhide

doi:10.1159/000470901

Cited by 4 publications

(3 citation statements)

References 15 publications

(22 reference statements)

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“…There are six limitations to this study, the first of which concerns the possibility of bias in the sub‐classification of esophageal motility disorders in the enrolled patients. In the studies to date that have investigated the sub‐classification of esophageal motility disorders in patients with dysphagia in Japan, 6,17,18 the results are consistent with those of our study cohort. Therefore, one would expect no major biases in registered patients with esophageal motility disorders.…”

Section: Discussionsupporting

confidence: 89%

Clinical significance of esophagogastroduodenoscopy in patients with esophageal motility disorders

Matsubara

Manabe

Ayaki

et al. 2020

Digestive Endoscopy

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Objectives The first aim of this study was to elucidate the detection rate of esophagogastroduodenoscopy (EGD) in patients complaining of dysphagia with esophageal motility disorders; the second was to clarify the useful parameters of EGD associated with esophageal motility disorders. Methods Participants included 380 patients who underwent EGD before high‐resolution manometry (HRM) for dysphagia. EGD findings were investigated according to the following five parameters: resistance when passing through the esophagogastric junction (EGJ), residue in the esophageal lumen, esophageal dilation, and spastic and nonocclusive contractions. HRM diagnoses were based on the Chicago classification (v3.0). Results The percentage of abnormal EGD findings was 64.4% among patients with esophageal motility disorders, and the results differed for each esophageal motility disorder. The rate of abnormal EGD for both EGJ outflow obstruction and major disorders of peristalsis was significantly higher than that for manometrically normal subjects. On multivariate analysis, resistance when passing through EGJ, residue in the esophageal lumen, spastic and nonocclusive contraction were significantly associated with esophageal motility disorders. The sensitivity, specificity, positive predictive value, and negative predictive value of these parameters for detection of esophageal motility disorders were 75.1%, 86.6%, 84.8% and 77.8%, respectively. Conclusion Esophagogastric junction outflow obstruction and major disorders of peristalsis can be screened with EGD. Among several endoscopic parameters, resistance when passing through EGJ, residue in the esophageal lumen, spastic and nonocclusive contraction are considered significantly useful indicators.

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Section: Discussionsupporting

confidence: 89%

Clinical significance of esophagogastroduodenoscopy in patients with esophageal motility disorders

Matsubara

Manabe

Ayaki

et al. 2020

Digestive Endoscopy

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“…Another study suggested that in the older population (> 60 years) with esophageal symptoms, the reduction in UES pressure, distal esophageal motility, and peristaltic velocity might be correlated with esophageal symptoms using HREM. 20 Nevertheless, Jadiri and colleagues reported no significant difference between young and old patients with dysphagia. 21 Furthermore, we found no correlation between smoking status and alcohol and opiate consumption and EMDs prevalence (P > 0.05).…”

Section: Resultsmentioning

confidence: 96%

Prevalence of Different Types of Primary Esophageal Motility Disorders and Their Associated Factors in Patients Referring to Shariati Hospital during 2018-2019

Assadian

Sanat

Soleimani

et al. 2022

Middle East J Dig Dis

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BACKGROUND: Esophageal motility disorders (EMDs) are common in patients with dysphagia and are effectively diagnosed with high-resolution manometry (HREM). In this study, we aimed to evaluate the prevalence of different types of primary EMDs in patients referred for HREM and to further investigate the factors associated with EMDs. METHODS: In this cross-sectional study, all patients referred to the endoscopy section of Shariati Hospital during 2018-2019 (279 patients) were subjected to HREM and were evaluated according to their diagnosis, and the effect of each factor and each symptom on motility disorders was investigated. RESULTS: 84.5% (235) of the participants were diagnosed with at least one esophageal motility disorder; of them, achalasia was the most common form (52.6%). None of the predictive factors showed a statistically significant correlation with EMDs. However, regarding the symptoms, regurgitation and nocturnal cough were significantly more common in patients with EMD (P=0.001 and 0.009, respectively). CONCLUSION: This study demonstrates the high prevalence of EMDs in patients undergoing manometry. None of the factors studied, such as age, sex, diabetes, hypothyroidism, smoking, and alcohol and opium consumption, had a statistically significant correlation with EMDs.

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“…We speculated that the visceral sensitivity may be associated with high UES pressure, but the results of the present study did not show a significant difference in the S/S genotype between the subgroups. For the complexity of the formation of UES pressure [24] and the mechanism of globus, this hypothesis requires further exploration. We observed that antidepressants decreased UES pressure.…”

Section: Discussionmentioning

confidence: 99%

Serotonin Transporter Gene (SLC6A4) Polymorphism May Be Associated with Chinese Globus Pharyngeus and Its Antidepressant Effects

et al. 2018

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Background: Although globus pharyngeus is not rare in clinical practice, little is known about its associated gene polymorphism. We investigated the association between the SLC6A4 polymorphism and globus pharyngeus and its response to treatment with antidepressants. Methods: A total of 84 patients were diagnosed with globus pharyngeus according to Rome III, and 160 healthy controls were genotyped for the SLC6A4 polymorphism using polymerase chain reaction amplification and agarose gel electrophoresis. All patients with globus were studied using high-resolution manometry pre-therapy. Globus patients were randomized into paroxetine or amitriptyline groups for a 6-week treatment and asked to complete the following pre- and post-therapy questionnaires: the Glasgow Edinburgh Throat Scale (GETS), the Pittsburgh Sleep Quality Index, and the Hamilton Rating Scale Anxiety/Depression. Treatment response was defined as a >50% reduction in the GETS scores. Results: A significant difference was observed in the globus S/S genotype with anxiety compared to that without anxiety (χ² = 14.579, p = 0.006). The L/S genotype showed a significant difference between high upper esophageal sphincter pressure (>104 mm Hg) and non-high upper esophageal sphincter pressure patients (χ² = 14.433, p = 0.006). A significant association between the S/S genotype and the response to antidepressant treatment was also observed, while patients with sleep disorders or depression showed no association. Conclusion: A significant association was observed between the S/S genotype of the SLC6A4 polymorphism and globus pharyngeus, suggesting that SLC6A4 is a potential candidate gene involved in the pathogenesis of globus pharyngeus.

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Exploratory Research on Latent Esophageal Motility Disorders in Dysphagia Patients

Cited by 4 publications

References 15 publications

Clinical significance of esophagogastroduodenoscopy in patients with esophageal motility disorders

Clinical significance of esophagogastroduodenoscopy in patients with esophageal motility disorders

Prevalence of Different Types of Primary Esophageal Motility Disorders and Their Associated Factors in Patients Referring to Shariati Hospital during 2018-2019

Serotonin Transporter Gene (SLC6A4) Polymorphism May Be Associated with Chinese Globus Pharyngeus and Its Antidepressant Effects

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