Hypercontractile Esophagus: Prevalence, Clinical and Manometric Characteristics in a Latin American Population
DOI:
https://doi.org/10.52787/agl.v52i2.204Keywords:
Hypercontractile esophagus, high-resolution manometry, dysphagia, chest pain, Chicago Classification v3.0, Chicago Classification v4.0Abstract
Introduction. Hypercontractile esophagus constitutes a spectrum of esophageal motor disorders that, according to the Chicago Classification v4.0, are characterized by the presence of hypercontractile peristaltic waves, with normal integrated relaxation pressure in high-resolution manometry and clinically relevant symptoms, such as dysphagia and/or non-cardiogenic chest pain. It is a relatively new entity, of which there are, until now, few publications referring to the Latin American population.
Aim. The aim of this study is to determine the prevalence according to the Chicago Classification v3.0 and 4.0, describing the manometric, demographic and clinical characteristics of this last group of patients.
Material and method. High-resolution esophageal manometries performed from January 2012 to December 2021 in the Neurogastroenterology section of the Hospital de Clínicas José de San Martín in Buenos Aires, Argentina, were analyzed.
Results. A total of 1,075 high-resolution esophageal manometries were analyzed, of which 13 (1.20%) met the diagnostic criteria for hypercontractile esophagus based on the Chicago Classification v3.0 and 10 (0.93%) with the Chicago Classification v4.0. The male: female ratio was 1:1. The median age was 66.5 years (range: 48-78 years).
The most frequent symptom was chest pain (80%), followed by esophageal dysphagia (60%). The median integrated distal contractility was 8,023 mmHg/s/cm (range: 30-26,500 mmHg/s/cm). The median integrated relaxation pressure was 12 mmHg (range: 4-20 mmHg). Regarding the treatment received, 70% responded to proton pump inhibitor, 20% to amitriptyline and 10% to botulinum toxin injection.
Conclusion. Hypercontractile esophagus has a low prevalence in our setting. The proportion of involvement according to sex was equal. The application of the new v4.0, being contextualized in a clinical spectrum, reduces the prevalence of this rare entity.
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Copyright (c) 2022 Harumi Hashimoto, Tatiana Uehara, Juan Montero, Liria Martinez, Esteban González Ballerga, Adriana Tevez
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