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Erschienen in: Digestive Diseases and Sciences 3/2012

01.03.2012 | Original Article

Clinical and Manometric Course of Nonspecific Esophageal Motility Disorders

verfasst von: Michaela Müller, Alexander J. Eckardt, Björn Göpel, Volker F. Eckardt

Erschienen in: Digestive Diseases and Sciences | Ausgabe 3/2012

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Abstract

Background and Aims

The evolution of nonspecific esophageal motility disorders remains unclear. The aim of this study was to investigate whether nonspecific esophageal motility disorders progress into specific motility disorders and whether such progression is predictable.

Methods

Seventy-six symptomatic patients (49 males, 27 females, mean age 57 ± 16 years) with newly diagnosed nonspecific esophageal motility disorders were prospectively registered and followed-up. Follow-up visits, with structured interviews and manometric re-evaluation, were recommended biannually and whenever symptoms exacerbated.

Results

Forty-three patients were followed for up to 4 years, symptoms worsened in 30% of patients, resolved in 26%, improved in 14% and were unchanged in 30%. Twenty-eight patients agreed to undergo manometric re-evaluation. Fifteen (53.6%) of these patients showed a progression to achalasia. The remaining patients continued to display features of nonspecific esophageal motility disorders (32%) or had normal motility (11%). The only significant association could be determined between age and progression to achalasia reaching nearly 100% in patients’ ≤46 years of age. In contrast, none of the patients’ ≥68 years progressed.

Conclusion

More than half of the patients in our cohort with nonspecific esophageal motility disorders showed a transition into achalasia. Neither manometric nor clinical findings predicted the progression of nonspecific esophageal motility disorders. However, young patients were more likely to progress to achalasia.
Literatur
1.
Zurück zum Zitat Benjamin SB, Castell DO. Esophageal causes of chest pain. In: Castell DO, Johnson LF, eds. Esophageal function in health and disease. New York: Elsevier; 1983:85–103. Benjamin SB, Castell DO. Esophageal causes of chest pain. In: Castell DO, Johnson LF, eds. Esophageal function in health and disease. New York: Elsevier; 1983:85–103.
2.
Zurück zum Zitat Richter JE, Bradley LA, Castell DO. Esophageal chest pain: current controversies in pathogenesis, diagnosis and therapy. Ann Intern Med. 1989;110:66–78.PubMed Richter JE, Bradley LA, Castell DO. Esophageal chest pain: current controversies in pathogenesis, diagnosis and therapy. Ann Intern Med. 1989;110:66–78.PubMed
3.
Zurück zum Zitat Benjamin SB, Gerhardt DC, Castell DO. High amplitude, peristaltic esophageal contractions associated with chest pain and/or dysphagia. Gastroenterology. 1979;77:478–483.PubMed Benjamin SB, Gerhardt DC, Castell DO. High amplitude, peristaltic esophageal contractions associated with chest pain and/or dysphagia. Gastroenterology. 1979;77:478–483.PubMed
4.
Zurück zum Zitat Hogan WJ, Caflisch CR, Winship DH. Unclassified oesophageal motor disorders simulating achalasia. Gut. 1969;10:234–240.PubMedCrossRef Hogan WJ, Caflisch CR, Winship DH. Unclassified oesophageal motor disorders simulating achalasia. Gut. 1969;10:234–240.PubMedCrossRef
5.
Zurück zum Zitat Achem SR, Crittenden J, Kolts B, Burton L. Long-term clinical and manometric follow-up of patients with nonspecific esophageal motor disorders. Am J Gastroenterol. 1992;87:825–830.PubMed Achem SR, Crittenden J, Kolts B, Burton L. Long-term clinical and manometric follow-up of patients with nonspecific esophageal motor disorders. Am J Gastroenterol. 1992;87:825–830.PubMed
6.
Zurück zum Zitat Vantrappen G, Janssens J, Hellemans J, Coremans G. Achalasia, diffuse esophageal spasm, and related motility disorders. Gastroenterology. 1979;76:450–457.PubMed Vantrappen G, Janssens J, Hellemans J, Coremans G. Achalasia, diffuse esophageal spasm, and related motility disorders. Gastroenterology. 1979;76:450–457.PubMed
7.
Zurück zum Zitat Eckardt VF. Clinical presentation and complications of achalasia. Gastrointest Endosc Clin N Am. 2001;11:281–292.PubMed Eckardt VF. Clinical presentation and complications of achalasia. Gastrointest Endosc Clin N Am. 2001;11:281–292.PubMed
8.
Zurück zum Zitat Kahrilas PJ, Clouse RE, Hogan WJ. American Gastroenterological Association technical review on the clinical use of esophageal manometry. Gastroenterology. 1994;107:1865–1884.PubMedCrossRef Kahrilas PJ, Clouse RE, Hogan WJ. American Gastroenterological Association technical review on the clinical use of esophageal manometry. Gastroenterology. 1994;107:1865–1884.PubMedCrossRef
9.
Zurück zum Zitat Katz PO, Richter JE, Cowan R, Castell DO. Apparent complete lower esophageal sphincter relaxation in achalasia. Gastroenterology. 1986;90:978–983.PubMed Katz PO, Richter JE, Cowan R, Castell DO. Apparent complete lower esophageal sphincter relaxation in achalasia. Gastroenterology. 1986;90:978–983.PubMed
10.
Zurück zum Zitat Richter JE, Blackwell JN, Wu WC, Johns DN, Cowan RJ, Castell DO. Relationship of radionuclide liquid bolus transport and esophageal manometry. J Lab Clin Med. 1987;109:217–224.PubMed Richter JE, Blackwell JN, Wu WC, Johns DN, Cowan RJ, Castell DO. Relationship of radionuclide liquid bolus transport and esophageal manometry. J Lab Clin Med. 1987;109:217–224.PubMed
11.
Zurück zum Zitat Richter JE, Wu WC, Johns DN, et al. Esophageal manometry in 95 healthy volunteers. Variability of pressures with age and frequency of “abnormal” contractions. Dig Dis Sci. 1987;32:583–592.PubMedCrossRef Richter JE, Wu WC, Johns DN, et al. Esophageal manometry in 95 healthy volunteers. Variability of pressures with age and frequency of “abnormal” contractions. Dig Dis Sci. 1987;32:583–592.PubMedCrossRef
12.
Zurück zum Zitat Richter JE, Castell DO. Diffuse esophageal spasm: a reappraisal. Ann Intern Med. 1984;100:242–245.PubMed Richter JE, Castell DO. Diffuse esophageal spasm: a reappraisal. Ann Intern Med. 1984;100:242–245.PubMed
13.
Zurück zum Zitat Freidin N, Traube M, Mittal RK, McCallum RW. The hypertensive lower esophageal sphincter. Manometric and clinical aspects. Dig Dis Sci. 1989;34:1063–1066.PubMedCrossRef Freidin N, Traube M, Mittal RK, McCallum RW. The hypertensive lower esophageal sphincter. Manometric and clinical aspects. Dig Dis Sci. 1989;34:1063–1066.PubMedCrossRef
14.
Zurück zum Zitat Katz PO, Dalton CB, Wu WC, Richter JE, Castell DO. Esophageal testing of patients with noncardiac chest pain or dysphagla. Results of three years’ experience with 1,161 patients. Ann Intern Med. 1987;106:593–596.PubMed Katz PO, Dalton CB, Wu WC, Richter JE, Castell DO. Esophageal testing of patients with noncardiac chest pain or dysphagla. Results of three years’ experience with 1,161 patients. Ann Intern Med. 1987;106:593–596.PubMed
15.
Zurück zum Zitat Sanderson DR, Ellis FH, Schlegel JF, Olsen AM. Syndrome of vigorous achalasia: clinical and physiological observations. Dis Chest. 1967;52:508–517.PubMedCrossRef Sanderson DR, Ellis FH, Schlegel JF, Olsen AM. Syndrome of vigorous achalasia: clinical and physiological observations. Dis Chest. 1967;52:508–517.PubMedCrossRef
16.
Zurück zum Zitat Shiflett DW, Wu WC, Ott DJ. Transition from nonspecific motility disorder to achalasia. Am J Gastroenterol. 1980;73:325–328.PubMed Shiflett DW, Wu WC, Ott DJ. Transition from nonspecific motility disorder to achalasia. Am J Gastroenterol. 1980;73:325–328.PubMed
17.
Zurück zum Zitat Naftali T, Levit T, Pomeranz I, Benjaminov FS, Konikoff FM. Nonspecific esophageal motility disorders may be an early stage of a specific disorder, particularly achalasia. Dis Esophagus. 2009;22:611–615.PubMedCrossRef Naftali T, Levit T, Pomeranz I, Benjaminov FS, Konikoff FM. Nonspecific esophageal motility disorders may be an early stage of a specific disorder, particularly achalasia. Dis Esophagus. 2009;22:611–615.PubMedCrossRef
18.
Zurück zum Zitat Reidel WL, Clouse RE. Variations in clinical presentation of patients with esophageal contraction abnormalities. Dig Dis Sci. 1985;30:1065–1071.PubMedCrossRef Reidel WL, Clouse RE. Variations in clinical presentation of patients with esophageal contraction abnormalities. Dig Dis Sci. 1985;30:1065–1071.PubMedCrossRef
19.
Zurück zum Zitat Leite LP, Johnston BT, Barrett J, Castell JA, Castell DO. Ineffective esophageal motility (IEM): the primary finding in patients with nonspecific esophageal motility disorder. Dig Dis Sci. 1997;42:1859–1865.PubMedCrossRef Leite LP, Johnston BT, Barrett J, Castell JA, Castell DO. Ineffective esophageal motility (IEM): the primary finding in patients with nonspecific esophageal motility disorder. Dig Dis Sci. 1997;42:1859–1865.PubMedCrossRef
20.
Zurück zum Zitat Agrawal A, Hila A, Tutuian R, Castell DO. Manometry and impedance characteristics of achalasia. Facts and myths. J Clin Gastroenterol. 2008;42:266–270.PubMedCrossRef Agrawal A, Hila A, Tutuian R, Castell DO. Manometry and impedance characteristics of achalasia. Facts and myths. J Clin Gastroenterol. 2008;42:266–270.PubMedCrossRef
21.
Zurück zum Zitat Francis DL, Katzka DA. Achalasia: update on the disease and its treatment. Gastroenterology. 2010;139:369–374.PubMedCrossRef Francis DL, Katzka DA. Achalasia: update on the disease and its treatment. Gastroenterology. 2010;139:369–374.PubMedCrossRef
22.
Zurück zum Zitat Richter JE. Achalasia—an update. J Neurogastroenterol Motil. 2010;6:222–232. Richter JE. Achalasia—an update. J Neurogastroenterol Motil. 2010;6:222–232.
23.
Zurück zum Zitat Soergel KH, Zboralske FF, Amberg JR. Presbyesophagus, esophageal motility in nonagenarians. J Clin Invest. 1964;45:1472–1479.CrossRef Soergel KH, Zboralske FF, Amberg JR. Presbyesophagus, esophageal motility in nonagenarians. J Clin Invest. 1964;45:1472–1479.CrossRef
24.
Zurück zum Zitat Eckardt VF, LeCompte PM. Esophageal ganglia and smooth muscle in the elderly. Dig Dis Sci. 1978;23:443–448.CrossRef Eckardt VF, LeCompte PM. Esophageal ganglia and smooth muscle in the elderly. Dig Dis Sci. 1978;23:443–448.CrossRef
25.
Zurück zum Zitat Robson KM, Glick ME. Dysphagie and advancing age: are manometric abnormalities more common in older patients? Dig Dis Sci. 2003;48:1709–1712.PubMedCrossRef Robson KM, Glick ME. Dysphagie and advancing age: are manometric abnormalities more common in older patients? Dig Dis Sci. 2003;48:1709–1712.PubMedCrossRef
26.
Zurück zum Zitat Achem AC, Achem SR, Stark ME, DeVault KR. Failure of esophageal peristalsis in older patients: association with esophageal acid exposure. Am J Gastroenterol. 2003;98:35–39.PubMedCrossRef Achem AC, Achem SR, Stark ME, DeVault KR. Failure of esophageal peristalsis in older patients: association with esophageal acid exposure. Am J Gastroenterol. 2003;98:35–39.PubMedCrossRef
Metadaten
Titel
Clinical and Manometric Course of Nonspecific Esophageal Motility Disorders
verfasst von
Michaela Müller
Alexander J. Eckardt
Björn Göpel
Volker F. Eckardt
Publikationsdatum
01.03.2012
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 3/2012
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-011-1937-y

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