IDDF2024-ABS-0259 Evaluation of esophageal motility disorders in patients with refractory reflux-like symptoms

<h3>Background</h3> Empirical treatment with a proton pump inhibitor is a recommended diagnostic strategy for gastroesophageal reflux disease. However, up to 40% of patients continue to experience reflux symptoms despite undergoing treatment. In such cases, it is crucial to consider the possibility of other esophageal mobility disorders, especially achalasia, which requires entirely different management. The study aimed to describe the prevalence of esophageal mobility disorders among individuals with refractory reflux-like symptoms and compare clinical symptoms and some parameters in high-resolution manometry (HRM) between patients with and without erosive esophagitis in endoscopic findings. <h3>Methods</h3> A descriptive study was conducted among 121 patients with refractory reflux-like symptoms performed HRM from January 2023 to January 2024 at Tam Anh General Hospital, Ho Chi Minh City, Vietnam. <h3>Results</h3> The mean of age was 46 ± 13 and 52,1% were males. According to the Chicago classification version 4.0, the proportions of esophageal motility groups were 38% normal, 7,4% achalasia, 23,1% esophagogastric junction outflow obstruction, 1,7% absent contractility, 24% ineffective esophageal motility and 5,8% distal esophageal spasm. The mean resting lower esophageal sphincter (LES) and 4-second integrated resting pressure (4s IRP) were significantly lower in the group with erosive esophagitis compared to the group without erosive esophagitis in endoscopic findings (23,3 ± 14,9 versus 33,4 ± 32,7 and 11,2 ± 11,1 versus 19,3 ± 25,9, respectively, p &lt; 0,05). After adjusting for some parameters, 4s IRP &lt; 5mmHg was positively associated with erosive esophagitis in endoscopic findings (OR 15,54; 95% confidence interval: 1,21 – 199,16; p = 0,035). <h3>Conclusions</h3> Ineffective esophageal mobility was the most common mobility disorder. 4s IRP &lt; 5mmHg was positively associated with erosive esophagitis in endoscopic findings.