Frequency and Patterns of Esophageal Motility Disorders among Patients with Refractory Esophageal Reflux Symptoms

Background: Esophageal motor function evaluation using High resolution manometry (HRM) can be useful in determining alternative diagnoses for patients with refractory esophageal reflux symptoms. Poor esophageal body peristaltic function and insufficient Esophageogastric junction (EGJ) barrier function is some of the pathophysiologic mechanisms behind refractory esophageal reflux symptoms that HRM may be able to detect. Methods: The study was conducted as cross-sectional descriptive study among 106 patients referred for Esophageal motility studying in Gastrointestinal Motility Unit in Ain Shams Specialized Hospital after obtaining administrative acceptance, Laborie MMS software was used with water perfused catheter. Data was analyzed according to Chicago Classification version 4.0 (CCv 4.0). Results: among 106 patients Females represented (51.9%) of patients and males represented (48.1%) of them. their age ranged from 18 to 70 years old. The duration of symptoms ranged from one to 8 years and GERD Q score ranged from 11 to 14. Gross endoscopic findings were detected in (95.3%) of patients. EMD were detected in (71.7%) of patients, nearly half (49.1%) of patients diagnosed as ineffective esophageal motility (IEM), while inconclusive IEM occurred in (5.7%), distal esophageal spasm occurred in (6.6%), absent contractility detected in (6.6%), hypercontractile esophagus occurred in (1.9%), and two cases (1.9%) were diagnosed with type 2 achalasia. Moreover, (79.2%) of patients had hiatus hernia (HH) on HRM, subdivided into (17%) subtype II and (62.3) subtype III EGJ morphology. Also, (49.1%) of patients had weak Lower esophageal sphincter (LES).