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Compartmentalized pressurization is a novel prognostic factor for hypercontractile esophagus
Andrew R Leopold1, Patrick McCarthy2, Anupama Nair1
1Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Neurogastroenterology and Motility
|November 20, 2023
Summary
Compartmentalized pressurization (CP) in hypercontractile esophagus (HE) is linked to worse symptoms and poor response to medical treatment. Identifying CP in HE may guide future treatment strategies for improved patient outcomes.
Area of Science:
- Gastroenterology
- Esophageal Motility Disorders
- High-Resolution Esophageal Manometry (HREM)
Background:
- Hypercontractile esophagus (HE) is characterized by increased esophageal body contractile strength.
- Compartmentalized pressurization (CP) is a manometric pattern not previously studied in relation to HE.
Purpose of the Study:
- To investigate the prevalence and clinical significance of CP in patients with HE.
- To determine if CP influences symptom severity and treatment response in HE patients.
Main Methods:
- Retrospective review of 830 HREM studies.
- Identification of HE patients using Chicago Classification v4.0.
- Analysis of CP status, Eckardt scores (ES), and treatment outcomes.
Main Results:
- 11 out of 30 (36.7%) HE patients exhibited CP.
- HE patients with CP had higher presenting ES (7 vs. 4) and were more likely associated with chronic opioid use (36.4% vs. 5.3%).
- HE patients with CP did not respond to medical therapy, unlike those without CP (0% vs. significant remission).
Conclusions:
- CP is associated with increased symptom severity in HE patients.
- CP in HE indicates a lack of response to medical therapy.
- CP may serve as a prognostic marker for guiding treatment decisions in HE.
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