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Article

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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Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
2
Department of Pharmacology, Wroclaw Medical University, Mikulicza-Radeckiego 2, 50-345 Wroclaw, Poland
*
Author to whom correspondence should be addressed.
Academic Editors: Giuseppe Parisi and Rodolfo Sacco
Int. J. Environ. Res. Public Health 2021, 18(21), 11138; https://doi.org/10.3390/ijerph182111138
Received: 6 September 2021 / Revised: 20 October 2021 / Accepted: 20 October 2021 / Published: 23 October 2021
(This article belongs to the Special Issue Advances in Gastroenterology, Hepatology and Clinical Nutrition)
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, p ≤ 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. View Full-Text
Keywords: diagnostic delay; esophageal motility disorders; gastrointestinal quality of life index; high-resolution manometry diagnostic delay; esophageal motility disorders; gastrointestinal quality of life index; high-resolution manometry
MDPI and ACS Style

Sarbinowska, J.; Wiatrak, B.; Waśko-Czopnik, D. 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. Int. J. Environ. Res. Public Health 2021, 18, 11138. https://doi.org/10.3390/ijerph182111138

AMA Style

Sarbinowska J, Wiatrak B, Waśko-Czopnik D. 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. International Journal of Environmental Research and Public Health. 2021; 18(21):11138. https://doi.org/10.3390/ijerph182111138

Chicago/Turabian Style

Sarbinowska, Joanna, Benita Wiatrak, and Dorota Waśko-Czopnik. 2021. "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" International Journal of Environmental Research and Public Health 18, no. 21: 11138. https://doi.org/10.3390/ijerph182111138

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