title: Habitual rapid food intake and ineffective esophageal motility.
abstract: OBJECTIVE
  To study non-cardiac chest pain (NCCP) in relation to ineffective esophageal motility (IEM) and rapid food intake.
  
  
  METHODS
  NCCP patients with a self-reported habit of fast eating underwent esophageal manometry for the diagnosis of IEM. Telephone interviews identified eating habits of additional IEM patients. Comparison of manometric features was done among IEM patients with and without the habit of rapid food intake and healthy controls. A case study investigated the effect of 6-mo gum chewing on restoration of esophageal motility in an IEM patient. The Valsalva maneuver was performed in IEM patients and healthy controls to assess the compliance of the esophagus in response to abdominal pressure increase.
  
  
  RESULTS
  Although most patients diagnosed with NCCP do not exhibit IEM, remarkably, all 12 NCCP patients who were self-reporting fast eaters with a main complaint of chest pain (75.0%) had contraction amplitudes in the mid and distal esophagus that were significantly lower compared with healthy controls [(23.45 mmHg (95%CI: 14.06-32.85) vs 58.80 mmHg (95%CI: 42.56-75.04), P < 0.01 and 28.29 mmHg (95%CI: 21.77-34.81) vs 50.75 mmHg (95%CI: 38.44-63.05), P < 0.01, respectively)]. In 7 normal-eating IEM patients with a main complaint of sensation of obstruction (42.9%), the mid amplitude was smaller than in the controls [30.09 mmHg (95%CI: 19.48-40.70) vs 58.80 mmHg (95%CI: 42.56-75.04), P < 0.05]. There was no statistically significant difference in manometric features between the fast-eating and normal-eating groups. One NCCP patient who self-reported fast eating and was subsequently diagnosed with IEM did not improve with proton-pump inhibition but restored swallow-induced contractions upon 6-mo gum-chewing. The Valsalva maneuver caused a markedly reduced pressure rise in the mid and proximal esophagus in the IEM patients.
  
  
  CONCLUSIONS
  Habitual rapid food intake may lead to IEM. A prospective study is needed to validate this hypothesis. Gum-chewing might strengthen weakened esophageal muscles.
authors.affiliation: Department of Gastroenterology and Hepatology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Kong-Ling
authors.initials: KL
authors.lastname: Li
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Chen
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.forename: Jan D
authors.initials: JD
authors.lastname: Huizinga
authors.forename: Shawn
authors.initials: S
authors.lastname: Vadakepeedika
authors.forename: Yu-Rong
authors.initials: YR
authors.lastname: Zhao
authors.forename: Wen-Zhen
authors.initials: WZ
authors.lastname: Yu
authors.forename: He-Sheng
authors.initials: HS
authors.lastname: Luo
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology*; D002638:Chewing Gum; D003679:Deglutition; D004435:Eating; D015154:Esophageal Motility Disorders / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008409:Mastication; D008875:Middle Aged; D053580:Muscle Strength; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014636:Valsalva Maneuver; D055815:Young Adult
chemical_list: D002638:Chewing Gum
keywords: Esophageal manometry; Ineffective esophageal motility; Non-cardiac chest pain; Rapid food intake; Valsalva maneuver