title: Esophageal motor disorders in adults with eosinophilic esophagitis.
abstract: BACKGROUND
  An association between eosinophilic esophagitis (EoE) and esophageal motility disorders has been described in small studies.
  
  
  OBJECTIVE
  The aim of this study was to describe the prevalence of esophageal motor disorders in a large cohort of adults with EoE and examine whether an association exists between esophageal dysmotility and dysphagia.
  
  
  METHODS
  A retrospective review of esophageal manometry studies in adult EoE patients was performed. Tracings were reviewed for abnormalities including nutcracker esophagus and ineffective swallows, defined as low amplitude peristalsis (<30 mmHg) or non-propagating contractions. Ineffective esophageal motility (IEM) was categorized as mild (30-40% ineffective swallows), moderate (50-60% ineffective swallows), and severe (≥70% ineffective swallows). Dysphagia was graded on a 0-3 scale for frequency and severity.
  
  
  RESULTS
  Seventy-five tracings from EoE patients were reviewed (85% male, mean age 41 ± 12 years). IEM was identified in 25 patients and categorized as mild (n = 13), moderate (n = 6), and severe (n = 6). Nutcracker esophagus was found in three patients. There was no significant difference in eosinophil count among the motility groups: normal 46.5 ± 3.1, mild IEM 56.9 ± 36.9, moderate IEM 45.5 ± 23.7, severe IEM 34.3 ± 12.6 (P = 0.157).
  
  
  CONCLUSIONS
  In this cohort of EoE patients, the majority had normal esophageal motility studies, although a subset of these patients had some esophageal dysmotility. It is unlikely that esophageal dysmotility is a major contributing factor to dysphagia, although it is reasonable to consider esophageal manometry testing in EoE patients to identify potential abnormalities of the smooth muscle esophagus.
authors.affiliation: Gastroenterology Service, Department of Medicine, Walter Reed Army Medical Center, 6900 Georgia Avenue, NW, Washington, DC 20307, USA. Fouad.Moawad@us.army.mil
authors.forename: Fouad J
authors.initials: FJ
authors.lastname: Moawad
authors.forename: Corinne L
authors.initials: CL
authors.lastname: Maydonovitch
authors.forename: Ganesh R
authors.initials: GR
authors.lastname: Veerappan
authors.forename: John T
authors.initials: JT
authors.lastname: Bassett
authors.forename: Jason M
authors.initials: JM
authors.lastname: Lake
authors.forename: Roy K H
authors.initials: RK
authors.lastname: Wong
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015154:Esophageal Motility Disorders / Q000503:physiopathology*; D050782:Esophageal pH Monitoring; D004941:Esophagitis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies