機能性ディスペプシア患者における高解像度食道内圧検査の役割：前向き観察研究

Functional dyspepsia (FD) is a prevalent gastrointestinal (GI) disorder characterized by persistent upper abdominal discomfort without identifiable structural abnormalities. Its pathophysiology remains poorly understood, and conventional diagnostic tools often fail to detect underlying motility disorders.

The objective of this study was to evaluate the role of high-resolution esophageal manometry (HRM) in diagnosing esophageal motility abnormalities in patients with FD and normal upper GI endoscopy findings.

This prospective observational study was conducted at Dr. D. Y. Patil Medical College, Pune, from January 2023 to March 2025. Thirty adult patients aged 18-60 years with persistent dyspeptic symptoms unresponsive to standard medical therapy and normal upper GI endoscopy were included. After Helicobacter pylori eradication therapy and proton pump inhibitor treatment, patients underwent HRM to assess esophageal motility. HRM findings were correlated with clinical symptoms to guide management decisions.

The study cohort had a mean age of 32.03 ± 8.8 years, with a female predominance (60%). Common symptoms included epigastric pain (80%), anorexia (60%), nausea/vomiting (53.3%), and regurgitation (50%). HRM revealed abnormal findings in 50% of patients, with the most frequent abnormalities being hypertensive upper esophageal sphincter (10%) and low amplitude contractions (10%). Based on HRM findings, 60% of patients underwent surgical interventions, whereas 40% received conservative management.

HRM identified clinically significant esophageal motility abnormalities in a substantial subset of patients with FD and normal endoscopic findings. These findings suggest that esophageal dysmotility may underlie persistent symptoms in such patients and support the integration of HRM into the diagnostic workup of refractory FD.