Korean J Gastroenterol.  2017 Apr;69(4):212-219. 10.4166/kjg.2017.69.4.212.

The Effect of Anti-reflux Therapy on Patients Diagnosed with Minor Disorders of Peristalsis in High-resolution Manometry

• Jeong J
• Kim SE
• Park MI
• Park SJ
• Moon W
• Kim JH
• Jung K
• Choi YJ
• Lee JY
• Lee YD

• KMID: 2383398
• DOI: http://doi.org/10.4166/kjg.2017.69.4.212

Abstract

BACKGROUND/AIMS
Minor disorders of peristalsis are esophageal motility disorders categorized by the Chicago Classification (CC), version 3.0, which was announced in 2014. This study evaluated the efficacy of anti-reflux therapy in patients with minor peristaltic disorders.
METHODS
Patients with minor peristaltic disorders in accordance with CC v3.0 were included. We reviewed the medical records of patients with esophageal high-resolution manometry findings, and investigated the demographic and clinical information as well as the medical therapy. Thereafter, the response to treatment was assessed after at least 4 weeks of treatment.
RESULTS
A total of 24 patients were identified as having minor disorders of peristalsis from January 2010 to December 2015. The mean follow-up period was 497 days, and there were 17 patients (70.8%) patients with ineffective esophageal motility. In terms of anti-reflux therapy, proton pump inhibitors (PPIs) with prokinetic agents and PPIs alone were prescribed in 19 patients (79.2%) and 5 patients (20.8%), respectively. When the rate of response to the treatment was assessed, the responders rate (complete+satisfactory [≥50%] responses) was 54.2% and the non-responders rate (partial [<50%]+refractory responses) was 45.8%. Patients in the responder group were younger than those in the non-responder group (p=0.020). Among them, 13 patients underwent 24-hour multichannel intraluminal impedance-pH, and 10 patients (76.9%) were pathologic gastroesophageal reflux.
CONCLUSIONS
The majority of esophageal minor peristaltic disorders were accompanied by gastroesophageal reflux, and therefore, they might respond to acid inhibitor. Further well-designed, prospective studies are necessary to confirm the effect of anti-reflux therapy in these patients.

Keyword

Esophageal motility disorders; Manometry; Treatment outcome; Proton pump inhibitors

MeSH Terms

Classification
Esophageal Motility Disorders
Follow-Up Studies
Gastroesophageal Reflux
Humans
Manometry*
Medical Records
Peristalsis*
Prospective Studies
Proton Pump Inhibitors
Proton Therapy
Treatment Outcome
Proton Pump Inhibitors

Reference

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