title: Prevalence of esophageal motility abnormalities increases with longer disease duration in adult patients with eosinophilic esophagitis.
abstract: BACKGROUND
  During the natural course of eosinophilic esophagitis (EoE), the risk for esophageal stricture formation increases. It remains unknown whether motility abnormalities in EoE also develop over time. We aimed to determine the relationship between disease duration, clinical characteristics, and manometric pattern of EoE patients.
  
  
  METHODS
  We compared esophageal high-resolution manometry (HRM) measurements of 31 adult EoE patients with HRM data from 31 GERD controls and 31 healthy controls. Subsequently, we assessed differences in disease duration and clinical characteristics between EoE patients with normal and those with abnormal esophageal motility.
  
  
  RESULTS
  In EoE patients, peristaltic integrity was more frequently failed (12 vs 6%) or weak (27 vs 15%; p < 0.001) compared with healthy controls; however, this pattern was also seen in GERD controls (failed 14%, weak 27%). We found no differences regarding symptoms and signs of EoE between EoE patients with normal (42%) and abnormal motility (58%). However, disease duration was longer in EoE patients with abnormal motility than in those with normal motility (13 (6-18) years vs 4 (1-11) years; p < 0.05). In EoE, but not GERD, disease duration was identified as a risk factor for abnormal motility (OR for each year 1.142; 95% CI 1.004-1.299), and with longer disease duration, the prevalence of abnormal motility increased from 36% (duration 0-5 years) to 83% (duration ≥16 years; p < 0.05).
  
  
  CONCLUSIONS
  Weak and failed peristaltic integrity are more often present in adult EoE patients than in healthy controls. The prevalence of manometric abnormalities in EoE patients increases with longer disease duration.
authors.affiliation: Department of Gastroenterology & Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Bram D
authors.initials: BD
authors.lastname: van Rhijn
authors.forename: Jac M
authors.initials: JM
authors.lastname: Oors
authors.forename: Andreas J P M
authors.initials: AJ
authors.lastname: Smout
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Bredenoord
mesh_terms: D000328:Adult; D057765:Eosinophilic Esophagitis / Q000453:epidemiology* / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015995:Prevalence; D013997:Time Factors
keywords: HRM; diagnostic delay; dysphagia; endoscopic signs; esophageal motility; histology; manometry; natural history; stenosis; stricture