High prevalence of esophagitis in patients with severe ineffective esophageal motility: need for a new diagnostic cutoff.

Autor:	Dao HV; Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam (Hang Viet Dao, Long Van Dao).; The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam (Hang Viet Dao, Long Bao Hoang, Minh-Hue Thi Luu, Long Van Dao)., Hoang LB; The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam (Hang Viet Dao, Long Bao Hoang, Minh-Hue Thi Luu, Long Van Dao)., Luu MT; The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam (Hang Viet Dao, Long Bao Hoang, Minh-Hue Thi Luu, Long Van Dao)., Nguyen HL; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA (Hoa Lan Nguyen, Robert Goldberg, Jeroan Allison)., Goldberg R; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA (Hoa Lan Nguyen, Robert Goldberg, Jeroan Allison)., Allison J; Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam (Hang Viet Dao, Long Van Dao).; The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam (Hang Viet Dao, Long Bao Hoang, Minh-Hue Thi Luu, Long Van Dao).; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA (Hoa Lan Nguyen, Robert Goldberg, Jeroan Allison).; School of Public Health, University of Queensland, Herston, Australia (Minh-An Thi Dao).; Epidemiology Department, Hanoi Medical University, Hanoi, Vietnam (Minh-An Thi Dao).; Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan (Tomoaki Matsumura)., Dao MT; School of Public Health, University of Queensland, Herston, Australia (Minh-An Thi Dao).; Epidemiology Department, Hanoi Medical University, Hanoi, Vietnam (Minh-An Thi Dao)., Matsumura T; Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan (Tomoaki Matsumura)., Dao LV; Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam (Hang Viet Dao, Long Van Dao).; The Institute of Gastroenterology and Hepatology, Hanoi, Vietnam (Hang Viet Dao, Long Bao Hoang, Minh-Hue Thi Luu, Long Van Dao).
Jazyk:	angličtina
Zdroj:	Annals of gastroenterology [Ann Gastroenterol] 2022 Sep-Oct; Vol. 35 (5), pp. 483-488. Date of Electronic Publication: 2022 Jul 11.
DOI:	10.20524/aog.2022.0733
Abstrakt:	Background: A new classification criterion for diagnosing ineffective esophageal motility (IEM) was proposed at the 2018 Stanford symposium, but limited data exists about the utility of this criterion. Methods: We conducted a cross-sectional study among 3826 patients treated at the Institute of Gastroenterology and Hepatology, Hanoi, Vietnam, between March 2018 and May 2020. Patients were classified as having normal motility, mild IEM, severe IEM, or absent contractility based on the Chicago classification version 3.0 and the new IEM criterion (severe IEM was defined as having >70% ineffective swallows). We examined the association between these 4 motility subgroups and the presence of erosive esophagitis and Barrett's esophagus, using multivariate logistic regression analysis. Results: The mean age of the study sample was 44.7 years and 66.3% were women. The prevalence of symptoms, hiatal hernia, and Helicobacter pylori -positive patients was similar in the 4 study groups. The 4-second integrated relaxation pressures and lower esophageal sphincter resting pressures were lower in patients with severe IEM and absent contractility. Severe IEM and absent contractility, but not mild IEM, were significantly associated with Los Angeles (LA) grade B-D esophagitis (relative risk ratio [RRR] for severe IEM 1.81, 95% confidence interval [CI] 1.17-2.80; and RRR for absent contractility 2.37, 95%CI 1.12-5.04). None of the hypomotility subgroups were associated with LA grade A esophagitis and Barrett's esophagus. Conclusions: Patients with severe IEM have a high prevalence of severe erosive esophagitis. These findings suggest the need for a more meaningful classification criterion for IEM. Competing Interests: Conflict of Interest: None (Copyright: © Hellenic Society of Gastroenterology.)
Databáze:	MEDLINE
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