Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study

Background: Esophageal dysmotility may be the cause or a secondary effect of gastric acid-dependent diseases: erosive reflux disease (ERD), Schatzki ring (SR) and eosinophilic esophagitis (EoE). Methods: This study aims to compare concomitant dysphagia with ERD, SR and EoE, considering manometric pa...

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Autores principales:	Joanna Sarbinowska, Benita Wiatrak, Dorota Waśko-Czopnik
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	diagnostic delay esophageal motility disorders gastrointestinal quality of life index high-resolution manometry Medicine R
Acceso en línea:	https://doaj.org/article/170b6e747b844ee3b862ed8130fb7e8b
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spelling	oai:doaj.org-article:170b6e747b844ee3b862ed8130fb7e8b2021-11-11T16:17:34ZEsophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study10.3390/ijerph1821111381660-46011661-7827https://doaj.org/article/170b6e747b844ee3b862ed8130fb7e8b2021-10-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11138https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601Background: Esophageal dysmotility may be the cause or a secondary effect of gastric acid-dependent diseases: erosive reflux disease (ERD), Schatzki ring (SR) and eosinophilic esophagitis (EoE). Methods: This study aims to compare concomitant dysphagia with ERD, SR and EoE, considering manometric patterns, their role in the natural history and their impact on assessing quality of life. Fifty-eight patients with dysphagia underwent high-resolution manometry and esophago-gastro-duodenoscopy (EGD) with an assessment of SR, ERD and sampling for EoE, completed a questionnaire with the Eating Assessment Tool (EAT-10) and the Gastrointestinal Quality of Life Index. Based on endoscopic images and the histopathological criterion of EoE (≥15 eosinophils/high-power field), patients were assigned to groups with ERD, EoE, SR and with normal endoscopic and histopathological images. In the data analysis, <i>p</i> ≤ 0.05 was considered statistically significant. This trial was registered with ClinicalTrials.gov (no. NCT04803162). Results: Both EoE, SR and ERD correlate with ineffective motility. In ERD, normal peristalsis precedes the development of the disease, unlike EoE, which develops later and leads to absent contractility. The development of SR is associated with disorders of the upper esophageal sphincter (UES). In the group with SR and ERD, UES insufficiency significantly reduces the quality of life. Patients with normal esophagus in EGD scored the lowest quality of life and those with SR had the most severe dysphagia. Conclusion: The esophageal motility disorders co-occurring with endoscopic and histological anomalies do not significantly affect the severity of dysphagia, however, in the case of patients with ERD and SR and concomitant UES insufficiency, this motor dysfunction has a significant impact on the reduction in the patients’ quality of life. Although no specific esophageal motility pattern typical of EoE, ERD and SR has been identified, comparative assessment of manometric features may have a potential role in differential diagnosis.Joanna SarbinowskaBenita WiatrakDorota Waśko-CzopnikMDPI AGarticlediagnostic delayesophageal motility disordersgastrointestinal quality of life indexhigh-resolution manometryMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11138, p 11138 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diagnostic delay esophageal motility disorders gastrointestinal quality of life index high-resolution manometry Medicine R
spellingShingle	diagnostic delay esophageal motility disorders gastrointestinal quality of life index high-resolution manometry Medicine R Joanna Sarbinowska Benita Wiatrak Dorota Waśko-Czopnik Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study
description	Background: Esophageal dysmotility may be the cause or a secondary effect of gastric acid-dependent diseases: erosive reflux disease (ERD), Schatzki ring (SR) and eosinophilic esophagitis (EoE). Methods: This study aims to compare concomitant dysphagia with ERD, SR and EoE, considering manometric patterns, their role in the natural history and their impact on assessing quality of life. Fifty-eight patients with dysphagia underwent high-resolution manometry and esophago-gastro-duodenoscopy (EGD) with an assessment of SR, ERD and sampling for EoE, completed a questionnaire with the Eating Assessment Tool (EAT-10) and the Gastrointestinal Quality of Life Index. Based on endoscopic images and the histopathological criterion of EoE (≥15 eosinophils/high-power field), patients were assigned to groups with ERD, EoE, SR and with normal endoscopic and histopathological images. In the data analysis, <i>p</i> ≤ 0.05 was considered statistically significant. This trial was registered with ClinicalTrials.gov (no. NCT04803162). Results: Both EoE, SR and ERD correlate with ineffective motility. In ERD, normal peristalsis precedes the development of the disease, unlike EoE, which develops later and leads to absent contractility. The development of SR is associated with disorders of the upper esophageal sphincter (UES). In the group with SR and ERD, UES insufficiency significantly reduces the quality of life. Patients with normal esophagus in EGD scored the lowest quality of life and those with SR had the most severe dysphagia. Conclusion: The esophageal motility disorders co-occurring with endoscopic and histological anomalies do not significantly affect the severity of dysphagia, however, in the case of patients with ERD and SR and concomitant UES insufficiency, this motor dysfunction has a significant impact on the reduction in the patients’ quality of life. Although no specific esophageal motility pattern typical of EoE, ERD and SR has been identified, comparative assessment of manometric features may have a potential role in differential diagnosis.
format	article
author	Joanna Sarbinowska Benita Wiatrak Dorota Waśko-Czopnik
author_facet	Joanna Sarbinowska Benita Wiatrak Dorota Waśko-Czopnik
author_sort	Joanna Sarbinowska
title	Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study
title_short	Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study
title_full	Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study
title_fullStr	Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study
title_full_unstemmed	Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study
title_sort	esophageal motility disorders in the natural history of acid-dependent causes of dysphagia and their influence on patients’ quality of life—a prospective cohort study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/170b6e747b844ee3b862ed8130fb7e8b
work_keys_str_mv	AT joannasarbinowska esophagealmotilitydisordersinthenaturalhistoryofaciddependentcausesofdysphagiaandtheirinfluenceonpatientsqualityoflifeaprospectivecohortstudy AT benitawiatrak esophagealmotilitydisordersinthenaturalhistoryofaciddependentcausesofdysphagiaandtheirinfluenceonpatientsqualityoflifeaprospectivecohortstudy AT dorotawaskoczopnik esophagealmotilitydisordersinthenaturalhistoryofaciddependentcausesofdysphagiaandtheirinfluenceonpatientsqualityoflifeaprospectivecohortstudy
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Esophageal Motility Disorders in the Natural History of Acid-Dependent Causes of Dysphagia and Their Influence on Patients’ Quality of Life—A Prospective Cohort Study

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