title: Characteristics of Consecutive Esophageal Motility Diagnoses After a Decade of Change.
abstract: OBJECTIVE
  Combined multichannel intraluminal impedance and esophageal manometry (MII-EM) measures concomitantly bolus transit and pressure changes allowing determination of the functional impact of esophageal motility abnormalities. Ten years ago our laboratory reported MII-EM results in 350 consecutive patients. Since then high-resolution impedance manometry (HRIM) became available and the definitions of ineffective esophageal motility (IEM) and nutcracker esophagus were revised. The aim of this study was to assess the impact of these developments on esophageal function testing.
  
  
  METHODS
  From August 2012 through May 2013, HRIM was performed in 350 patients referred for esophageal function testing. Each patient received 10 liquid and 10 viscous swallows. While taking advantage of the new technology and revised criteria, HRIM findings were classified according to the conventional criteria to allow more appropriate comparison with our earlier analysis.
  
  
  RESULTS
  Compared with the study performed 10 years ago, the prevalence of normal manometry (36% vs. 35%), achalasia (7% vs. 8%), scleroderma (1% vs. 1%), hypertensive lower esophageal sphincter (LES) (7% vs. 7%), and hypotensive LES (1% vs. 2%) remained the same, whereas the prevalence of distal esophageal spasm (9% vs. 3%), nutcracker esophagus (9% vs. 3%), and poorly relaxing LES (10% vs. 3%) decreased and the prevalence of IEM increased (20% vs. 31%) significantly. Compared with the early study, normal liquid bolus transit was significantly different in patients with hypertensive LES (96% vs. 57%) and poorly relaxing LES (55% vs. 100%).
  
  
  CONCLUSIONS
  This study brings to light the increase in prevalence of IEM. In addition, it suggests that the hypertensive LES and poorly relaxing LES may each affect bolus transit in about half of these patients.
authors.affiliation: *Department of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC†Bern University Hospital, Bern, Switzerland.
authors.forename: Katherine
authors.initials: K
authors.lastname: Boland
authors.forename: Mustafa
authors.initials: M
authors.lastname: Abdul-Hussein
authors.forename: Radu
authors.initials: R
authors.lastname: Tutuian
authors.forename: Donald O
authors.initials: DO
authors.lastname: Castell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition; D017097:Electric Impedance; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011312:Pressure; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013022:South Carolina; D013997:Time Factors; D055815:Young Adult