title: Esophageal dysmotility in children with eosinophilic esophagitis: a study using prolonged esophageal manometry.
abstract: OBJECTIVE
  The pathophysiology of dysphagia in patients with eosinophilic esophagitis (EoE) is unknown but may be related to abnormal esophageal motor function. Symptoms rarely occur during stationary esophageal manometry, so it has been difficult to establish an association between symptoms and motor events. Our aim was to evaluate esophageal motor function in children with EoE with the use of stationary manometry and ambulatory prolonged esophageal manometry and pH-metry (PEMP).
  
  
  METHODS
  PEMP was performed in children with EoE and compared with controls and children with gastroesophageal reflux disease (GERD). Peristalsis was considered effective when the esophageal contractions had a normal amplitude and propagation. Results are expressed as mean+/-s.e.
  
  
  RESULTS
  Seventeen patients with EoE, 13 with GERD, and 11 controls were studied. Values are expressed as mean+/-s.e. Stationary manometry identified abnormal peristalsis in 41% of children with EoE. During PEMP, children with EoE had an increased number of isolated (16.7+/-3.8 vs. 9.5+/-1.6 vs. 6.5+/-1.1; P<0.03) and high-amplitude contractions (4.1+/-1.2 vs. 1.8+/-0.8 vs. 0.1+/-0.1; P<0.03), and higher percentage ineffective peristalsis both during fasting (70.5%+/-2.5 vs. 57.8%+/-3.0 vs. 53.8%+/-1.9; P<0.05) and during meals (68.4+/-3.4 vs. 55.3+/-2.8 vs. 48.1+/-2.8; P<0.05) when compared with children with GERD and controls. Thirteen patients with EoE experienced 21 episodes of dysphagia, and all correlated with simultaneous abnormal motor function.
  
  
  CONCLUSIONS
  PEMP allowed the detection of ineffective peristalsis in children with EoE. Symptoms observed in children with EoE may be related to esophageal motor dysfunction.
authors.affiliation: Center for Motility and Functional Gastrointestinal Disorders, and Eosinophilic Gastrointestinal Diseases Program, Children's Hospital Boston, Boston, Massachusetts 02155, USA. samuel.nurko@childrens.harvard.edu
authors.forename: Samuel
authors.initials: S
authors.lastname: Nurko
authors.forename: Rachel
authors.initials: R
authors.lastname: Rosen
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Furuta
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D004802:Eosinophilia / Q000503:physiopathology*; D015154:Esophageal Motility Disorders / Q000503:physiopathology; D050782:Esophageal pH Monitoring; D004941:Esophagitis / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D011446:Prospective Studies