Skip to main content
Erschienen in: Digestive Diseases and Sciences 12/2018

26.06.2018 | Original Article

A Positive Correlation Between Gastric and Esophageal Dysmotility Suggests Common Causality

verfasst von: Thomas A. Zikos, John O. Clarke, George Triadafilopoulos, Kirsten A. Regalia, Irene S. Sonu, Nielsen Q. Fernandez-Becker, Monica C. Nandwani, Linda A. Nguyen

Erschienen in: Digestive Diseases and Sciences | Ausgabe 12/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Gastric and esophageal dysmotility syndromes are some of the most common motility diagnoses, but little is known about their interrelationship.

Aims

The aim of our study was to determine if a correlation exists between gastric and esophageal dysmotility syndromes.

Methods

We reviewed the records of all patients who underwent both solid gastric emptying scintigraphy (GES) and high-resolution esophageal manometry (HRM) within a 2 year period, with both done between August 2012 and August 2017. All GESs were classified as either rapid, normal, or delayed. All HRMs were classified according to the Chicago Classification 3.0. Correlations were assessed using Fisher’s exact test and multiple logistic regression.

Results

In total, 482 patients met inclusion criteria. Of patients with a normal, delayed, and rapid GES, 53.1, 64.5, and 77.3% had an abnormal HRM, respectively (p < 0.05 vs. normal GES). Likewise, patients with an abnormal HRM were more likely to have an abnormal GES (54.9 vs. 41.8%, p = 0.005). Multiple logistic regression showed abnormal GES [odds ratio (OR) 2.14], age (OR 1.013), scleroderma (OR 6.29), and dysphagia (OR 2.63) were independent predictors of an abnormal HRM. Likewise, an abnormal HRM (OR 2.11), diabetes (OR 1.85), heart or lung transplantation (OR 2.61), and autonomic dysfunction (OR 2.37) were independent predictors of an abnormal GES.

Conclusions

The correlation between an abnormal GES and HRM argues for common pathogenic mechanisms of these motility disorders, and possibly common future treatment options. Clinicians should have a high index of suspicion for another motility disorder if one is present.
Literatur
1.
Zurück zum Zitat Jung HK, Choung RS, Locke GR III, et al. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009;136:1225–1233.CrossRef Jung HK, Choung RS, Locke GR III, et al. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009;136:1225–1233.CrossRef
2.
Zurück zum Zitat Boland K, Abdul-Hussein M, Tutuian R, Castell DO. Characteristics of consecutive esophageal motility diagnoses after a decade of change. J Clin Gastroenterol. 2016;50:301–306.CrossRef Boland K, Abdul-Hussein M, Tutuian R, Castell DO. Characteristics of consecutive esophageal motility diagnoses after a decade of change. J Clin Gastroenterol. 2016;50:301–306.CrossRef
3.
Zurück zum Zitat Liu N, Abell T. Gastroparesis updates on pathogenesis and management. Gut Liver. 2017;11:579–589.CrossRef Liu N, Abell T. Gastroparesis updates on pathogenesis and management. Gut Liver. 2017;11:579–589.CrossRef
4.
Zurück zum Zitat Marie I, Gourcerol G, Leroi AM, Menard JF, Levesque H, Ducrotte P. Delayed gastric emptying determined using the 13C-octanoic acid breath test in patients with systemic sclerosis. Arthritis Rheum. 2012;64:2346–2355.CrossRef Marie I, Gourcerol G, Leroi AM, Menard JF, Levesque H, Ducrotte P. Delayed gastric emptying determined using the 13C-octanoic acid breath test in patients with systemic sclerosis. Arthritis Rheum. 2012;64:2346–2355.CrossRef
5.
Zurück zum Zitat Ebert EC. Esophageal disease in scleroderma. J Clin Gastroenterol. 2006;40:769–775.CrossRef Ebert EC. Esophageal disease in scleroderma. J Clin Gastroenterol. 2006;40:769–775.CrossRef
6.
Zurück zum Zitat Gustafsson RJ, Littorin B, Berntorp K, et al. Esophageal dysmotility is more common than gastroparesis in diabetes mellitus and is associated with retinopathy. Rev Diabet Stud. 2011;8:268–275.CrossRef Gustafsson RJ, Littorin B, Berntorp K, et al. Esophageal dysmotility is more common than gastroparesis in diabetes mellitus and is associated with retinopathy. Rev Diabet Stud. 2011;8:268–275.CrossRef
7.
Zurück zum Zitat Suttrup I, Warnecke T. Dysphagia in Parkinson’s disease. Dysphagia. 2016;31:24–32.CrossRef Suttrup I, Warnecke T. Dysphagia in Parkinson’s disease. Dysphagia. 2016;31:24–32.CrossRef
8.
Zurück zum Zitat Rubinow A, Burakoff R, Cohen AS, Harris LD. Esophageal manometry in systemic amyloidosis. A study of 30 patients. Am J Med. 1983;75:951–956.CrossRef Rubinow A, Burakoff R, Cohen AS, Harris LD. Esophageal manometry in systemic amyloidosis. A study of 30 patients. Am J Med. 1983;75:951–956.CrossRef
9.
Zurück zum Zitat Tangaroonsanti A, Lee AS, Crowell MD, et al. Impaired esophageal motility and clearance post-lung transplant: risk for chronic allograft failure. Clin Transl Gastroenterol. 2017;8:e102.CrossRef Tangaroonsanti A, Lee AS, Crowell MD, et al. Impaired esophageal motility and clearance post-lung transplant: risk for chronic allograft failure. Clin Transl Gastroenterol. 2017;8:e102.CrossRef
10.
Zurück zum Zitat Raviv Y, D’Ovidio F, Pierre A, et al. Prevalence of gastroparesis before and after lung transplantation and its association with lung allograft outcomes. Clin Transplant. 2012;26:133–142.CrossRef Raviv Y, D’Ovidio F, Pierre A, et al. Prevalence of gastroparesis before and after lung transplantation and its association with lung allograft outcomes. Clin Transplant. 2012;26:133–142.CrossRef
11.
Zurück zum Zitat Faraj J, Melander O, Sundkvist G, et al. Oesophageal dysmotility, delayed gastric emptying and gastrointestinal symptoms in patients with diabetes mellitus. Diabet Med. 2007;24:1235–1239.CrossRef Faraj J, Melander O, Sundkvist G, et al. Oesophageal dysmotility, delayed gastric emptying and gastrointestinal symptoms in patients with diabetes mellitus. Diabet Med. 2007;24:1235–1239.CrossRef
12.
Zurück zum Zitat Ohlsson B, Melander O, Thorsson O, Olsson R, Ekberg O, Sundkvist G. Oesophageal dysmotility, delayed gastric emptying and autonomic neuropathy correlate to disturbed glucose homeostasis. Diabetologia. 2006;49:2010–2014.CrossRef Ohlsson B, Melander O, Thorsson O, Olsson R, Ekberg O, Sundkvist G. Oesophageal dysmotility, delayed gastric emptying and autonomic neuropathy correlate to disturbed glucose homeostasis. Diabetologia. 2006;49:2010–2014.CrossRef
13.
Zurück zum Zitat Lowe HJ, Ferris TA, Hernandez PM, Weber SC. STRIDE—an integrated standards-based translational research informatics platform. AMIA Annu Symp Proc. 2009;2009:391–395.PubMedPubMedCentral Lowe HJ, Ferris TA, Hernandez PM, Weber SC. STRIDE—an integrated standards-based translational research informatics platform. AMIA Annu Symp Proc. 2009;2009:391–395.PubMedPubMedCentral
14.
Zurück zum Zitat Abell TL, Camilleri M, Donohoe K, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. J Nucl Med Technol. 2008;36:44–54.CrossRef Abell TL, Camilleri M, Donohoe K, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. J Nucl Med Technol. 2008;36:44–54.CrossRef
15.
Zurück zum Zitat Kahrilas PJ, Bredenoord AJ, Fox M, et al. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015;27:160–174.CrossRef Kahrilas PJ, Bredenoord AJ, Fox M, et al. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015;27:160–174.CrossRef
17.
Zurück zum Zitat Putra J, Muller KE, Hussain ZH, et al. Lymphocytic esophagitis in nonachalasia primary esophageal motility disorders: improved criteria, prevalence, strength of association, and natural history. Am J Surg Pathol. 2016;40:1679–1685.CrossRef Putra J, Muller KE, Hussain ZH, et al. Lymphocytic esophagitis in nonachalasia primary esophageal motility disorders: improved criteria, prevalence, strength of association, and natural history. Am J Surg Pathol. 2016;40:1679–1685.CrossRef
18.
Zurück zum Zitat Grover M, Bernard CE, Pasricha PJ, et al. Clinical-histological associations in gastroparesis: results from the Gastroparesis Clinical Research Consortium. Neurogastroenterol Motil. 2012;24:531–539, e249.CrossRef Grover M, Bernard CE, Pasricha PJ, et al. Clinical-histological associations in gastroparesis: results from the Gastroparesis Clinical Research Consortium. Neurogastroenterol Motil. 2012;24:531–539, e249.CrossRef
19.
Zurück zum Zitat Lawal A, Barboi A, Krasnow A, Hellman R, Jaradeh S, Massey BT. Rapid gastric emptying is more common than gastroparesis in patients with autonomic dysfunction. Am J Gastroenterol. 2007;102:618–623.CrossRef Lawal A, Barboi A, Krasnow A, Hellman R, Jaradeh S, Massey BT. Rapid gastric emptying is more common than gastroparesis in patients with autonomic dysfunction. Am J Gastroenterol. 2007;102:618–623.CrossRef
20.
Zurück zum Zitat Malik Z, Sankineni A, Parkman HP. Assessing pyloric sphincter pathophysiology using EndoFLIP in patients with gastroparesis. Neurogastroenterol Motil. 2015;27:524–531.CrossRef Malik Z, Sankineni A, Parkman HP. Assessing pyloric sphincter pathophysiology using EndoFLIP in patients with gastroparesis. Neurogastroenterol Motil. 2015;27:524–531.CrossRef
21.
Zurück zum Zitat Khashab MA, Ngamruengphong S, Carr-Locke D, et al. Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2017;85:123–128.CrossRef Khashab MA, Ngamruengphong S, Carr-Locke D, et al. Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2017;85:123–128.CrossRef
22.
Zurück zum Zitat Arts J, Holvoet L, Caenepeel P, et al. Clinical trial: a randomized-controlled crossover study of intrapyloric injection of botulinum toxin in gastroparesis. Aliment Pharmacol Ther. 2007;26:1251–1258.CrossRef Arts J, Holvoet L, Caenepeel P, et al. Clinical trial: a randomized-controlled crossover study of intrapyloric injection of botulinum toxin in gastroparesis. Aliment Pharmacol Ther. 2007;26:1251–1258.CrossRef
23.
Zurück zum Zitat Friedenberg FK, Palit A, Parkman HP, Hanlon A, Nelson DB. Botulinum toxin A for the treatment of delayed gastric emptying. Am J Gastroenterol. 2008;103:416–423.CrossRef Friedenberg FK, Palit A, Parkman HP, Hanlon A, Nelson DB. Botulinum toxin A for the treatment of delayed gastric emptying. Am J Gastroenterol. 2008;103:416–423.CrossRef
24.
Zurück zum Zitat Pandolfino JE, Gawron AJ. Achalasia: a systematic review. JAMA. 2015;313:1841–1852.CrossRef Pandolfino JE, Gawron AJ. Achalasia: a systematic review. JAMA. 2015;313:1841–1852.CrossRef
Metadaten
Titel
A Positive Correlation Between Gastric and Esophageal Dysmotility Suggests Common Causality
verfasst von
Thomas A. Zikos
John O. Clarke
George Triadafilopoulos
Kirsten A. Regalia
Irene S. Sonu
Nielsen Q. Fernandez-Becker
Monica C. Nandwani
Linda A. Nguyen
Publikationsdatum
26.06.2018
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 12/2018
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5175-4

Weitere Artikel der Ausgabe 12/2018

Digestive Diseases and Sciences 12/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.