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The clinical significance of hypercontractile peristalsis: comparison of high-resolution manometric features, demographics, symptom presentation, and response to therapy in patients with Jackhammer esophagus versus Nutcracker esophagus.
- Source :
-
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus [Dis Esophagus] 2017 Dec 01; Vol. 30 (12), pp. 1-7. - Publication Year :
- 2017
-
Abstract
- The Chicago Classification version 3.0 (CC v 3.0) defines hypercontractile peristalsis as Jackhammer esophagus (JE); Nutcracker esophagus (NE) is no longer recognized. Data regarding patient characteristics and treatment response for JE versus NE are limited. We aimed to compare demographic characteristics, high resolution manometry (HRM) features, clinical presentation, management strategies, and treatment outcomes in patients with JE versus NE. We performed a retrospective analysis of adult patients diagnosed with NE (CC v 2.0) or JE (CC v 3.0) by HRM from January 2012 to August 2015. Demographics, symptoms, treatments, and response to therapy (none or partial/complete) were ascertained by chart review, for statistical comparisons. In 45 patients with JE and 29 with NE, there was no significant difference in rate of dysphagia (73% and 59%) or chest pain (44% and 59%). Treatment data were available in 29 JE (smooth muscle relaxants in 4, pain modulators in 3, botulinum toxin injection (BTX) in 10, endoscopic dilation in 5, multimodal treatment in 7), and 20 NE patients (smooth muscle relaxants in 2, pain modulators in 2, (BTX) in 6, endoscopic dilation in 3, multimodal treatment in 7). Follow-up data on 26/29 JE and 20/20 NE patients showed similar treatment response (96.4% vs. 82.1%, p= 0.08) after mean follow-up of 11.2 and 11 months, respectively. There were no major differences for JE versus NE in demographics, symptoms, or type of and response to therapy. Larger prospective, controlled trials are needed to clarify the clinical significance and response to treatment in JE and NE.<br /> (© The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Acetylcholine Release Inhibitors therapeutic use
Aged
Botulinum Toxins therapeutic use
Chest Pain etiology
Combined Modality Therapy
Dilatation
Esophageal Motility Disorders complications
Female
Follow-Up Studies
Heartburn etiology
Humans
Laryngopharyngeal Reflux etiology
Male
Middle Aged
Parasympatholytics therapeutic use
Retrospective Studies
Selective Serotonin Reuptake Inhibitors therapeutic use
Treatment Outcome
Esophageal Motility Disorders physiopathology
Esophageal Motility Disorders therapy
Manometry methods
Peristalsis
Subjects
Details
- Language :
- English
- ISSN :
- 1442-2050
- Volume :
- 30
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
- Publication Type :
- Academic Journal
- Accession number :
- 28881883
- Full Text :
- https://doi.org/10.1093/dote/dox085