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Dysphagia Worsens With Increasing Ineffective Swallows Among Patients With Ineffective Esophageal Motility.

Publication ,  Journal Article
Rangan, V; Nee, J; Li, B; Lembo, AJ; Leiman, DA
Published in: J Clin Gastroenterol
August 1, 2023

INTRODUCTION: Ineffective esophageal motility (IEM) is the most common motility disorder identified on esophageal high-resolution manometry (HRM), but patients with this finding may be asymptomatic. Therefore, we aimed to identify specific HRM findings predictive of symptoms in IEM. METHODS: Adult patients (≥18 y) who underwent HRM between March 2016 and July 2019 were retrospectively evaluated and reclassified according to Chicago Classification 4.0 (CC4.0). Demographic information, HRM parameters, and gastroesophageal reflux disease Health-Related Quality of Life Questionnaire responses were captured among those with normal manometry or IEM. We evaluated the association between heartburn, regurgitation, and dysphagia, with respect to HRM findings including ineffective swallows. RESULTS: Of 379 patients, 243 (64.1%) had a normal manometry, 136 (35.9%) were on IEM spectrum, and 73 (19.3%) had conclusive IEM by CC4.0. Mean dysphagia scores were significantly higher in those with conclusive IEM compared with those with normal HRM (2.00 vs. 1.36, P =0.002), as was the percentage of individuals reporting dysphagia affecting daily activities (21.9% vs. 11.4%, P =0.02). Heartburn and regurgitation symptoms did not differ between groups. In a multivariable model of IEM patients, the percentage of ineffective swallows independently predicted a higher dysphagia burden (β regression coefficient: 0.032, P =0.04). CONCLUSIONS: Applying the CC4.0 definition for conclusive IEM identifies a group of patients with worse dysphagia symptoms. Within this group, the percentage of ineffective swallows was an independent predictor of dysphagia severity. These findings may help practitioners and patients contextualize the heterogeneous diagnosis of IEM.

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Published In

J Clin Gastroenterol

DOI

EISSN

1539-2031

Publication Date

August 1, 2023

Volume

57

Issue

7

Start / End Page

694 / 699

Location

United States

Related Subject Headings

  • Vomiting
  • Swallows
  • Retrospective Studies
  • Quality of Life
  • Manometry
  • Humans
  • Heartburn
  • Gastroenterology & Hepatology
  • Esophageal Motility Disorders
  • Deglutition Disorders
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Rangan, V., Nee, J., Li, B., Lembo, A. J., & Leiman, D. A. (2023). Dysphagia Worsens With Increasing Ineffective Swallows Among Patients With Ineffective Esophageal Motility. J Clin Gastroenterol, 57(7), 694–699. https://doi.org/10.1097/MCG.0000000000001738
Rangan, Vikram, Judy Nee, Brian Li, Anthony J. Lembo, and David A. Leiman. “Dysphagia Worsens With Increasing Ineffective Swallows Among Patients With Ineffective Esophageal Motility.J Clin Gastroenterol 57, no. 7 (August 1, 2023): 694–99. https://doi.org/10.1097/MCG.0000000000001738.
Rangan V, Nee J, Li B, Lembo AJ, Leiman DA. Dysphagia Worsens With Increasing Ineffective Swallows Among Patients With Ineffective Esophageal Motility. J Clin Gastroenterol. 2023 Aug 1;57(7):694–9.
Rangan, Vikram, et al. “Dysphagia Worsens With Increasing Ineffective Swallows Among Patients With Ineffective Esophageal Motility.J Clin Gastroenterol, vol. 57, no. 7, Aug. 2023, pp. 694–99. Pubmed, doi:10.1097/MCG.0000000000001738.
Rangan V, Nee J, Li B, Lembo AJ, Leiman DA. Dysphagia Worsens With Increasing Ineffective Swallows Among Patients With Ineffective Esophageal Motility. J Clin Gastroenterol. 2023 Aug 1;57(7):694–699.

Published In

J Clin Gastroenterol

DOI

EISSN

1539-2031

Publication Date

August 1, 2023

Volume

57

Issue

7

Start / End Page

694 / 699

Location

United States

Related Subject Headings

  • Vomiting
  • Swallows
  • Retrospective Studies
  • Quality of Life
  • Manometry
  • Humans
  • Heartburn
  • Gastroenterology & Hepatology
  • Esophageal Motility Disorders
  • Deglutition Disorders