Prevalence of Motility Disorders in Patients with Esophageal Symptoms

Abstract

Introduction. Patients with esophageal motor disorders may present different symptoms. Dysphagia is the most common symptom, but it may also present with reflux symptoms (mainly regurgitation) and/or chest pain. Data on the prevalence of esophageal motility disorders, according to the different presenting symptoms in the Argentine population, are scarce. 

Aim. To describe the symptom profile and determine the prevalence of esophageal motility disorders based on each symptom. 

Material and methods. Retrospective analysis of prospectively conducted studies. Patients with esophageal symptoms who underwent high-resolution esophageal manometry from January 2009 to December 2020 were included. High-resolution manometry was performed with a system of 36 circumferentially sensitive solid-state sensors and patients were classified using the Chicago Classification v3.0. 

Results. Of the 861 patients studied (mean age 57 +/- 16 years; 71.2% women), 304 had dysphagia, 462 had gastroesophageal reflux symptoms, 89 had chest pain, and 6 had a combination of symptoms. Among patients with dysphagia, 38.16% had achalasia. Among patients with gastroesophageal reflux symptoms, 63.2% had normal esophageal motility and 18% had ineffective esophageal motility. Among patients with chest pain, 67% had normal esophageal motility and 13% had ineffective esophageal motility. The odds ratio for achalasia in patients with dysphagia was 38 (95% CI 19-86, p = 0.000). 

Conclusion. Gastroesophageal reflux symptoms were the most common presentation, followed by dysphagia. Achalasia was the most common manometric finding in patients with dysphagia and ineffective esophageal motility in patients with gastroesophageal reflux and chest pain. This study highlights the high prevalence of achalasia in patients with dysphagia and ineffective esophageal motility in patients with gastroesophageal reflux and chest pain.