Abstract
Functional dysphagia (FD) is characterized by the presence of dysphagia without evidence of mechanical esophageal obstruction, GERD, and histopathology-based esophageal motor disorders. Dysphagia is common in older patients; however, there is a paucity of information regarding the type and frequency of peristaltic abnormalities compared to younger patients. Based on recently validated criteria for classification of weak peristalsis using high-resolution manometry (HRM), we hypothesized that older patients with FD would have more peristaltic defects detected by HRM compared to younger FD patients. A retrospective review of our motility database yielded 65 patients that met inclusion criteria. Patients were divided into two groups based on age (younger: <70 years; older: ≥70 years). Patients were interviewed, completed a quality-of-life questionnaire, and underwent solid-state HRM. The two groups differed in age but in no other demographic characteristics, severity of dysphagia, or quality of life. Dyspeptic symptoms, including nausea (p < 0.001), early satiety (p = 0.01), bloating (p = 0.02), and belching (p = 0.01), were also more prevalent in younger FD patients. Older age was associated with weak peristalsis involving frequent failed peristalsis, small proximal peristaltic defects (2-5 cm), and large proximal peristaltic defects (>5 cm) (p < 0.001). The mean contraction amplitude was also lower in the older group (p < 0.05). These data support the hypothesis that older patients with FD have a higher frequency of peristaltic abnormalities on HRM compared to younger patients. Older age was associated with increased frequency of weak peristalsis with small and large peristaltic defects.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 519-526 |
| Number of pages | 8 |
| Journal | Dysphagia |
| Volume | 29 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2014 |
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Keywords
- Age
- Esophageal pressure topography
- Functional dysphagia
- High-resolution manometry
- Nonobstructive dysphagia
ASJC Scopus subject areas
- Otorhinolaryngology
- Gastroenterology
- Speech and Hearing
Cite this
Esophageal peristaltic defects in adults with functional dysphagia. / Ratuapli, Shiva K.; Hansel, Stephanie L.; Umar, Sarah B.; Burdick, George E.; Ramirez, Francisco C; Fleischer, David E.; Harris, Lucinda A.; Lacy, Brian E.; DiBaise, John K.; Crowell, Michael D.
In: Dysphagia, Vol. 29, No. 4, 2014, p. 519-526.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Esophageal peristaltic defects in adults with functional dysphagia
AU - Ratuapli, Shiva K.
AU - Hansel, Stephanie L.
AU - Umar, Sarah B.
AU - Burdick, George E.
AU - Ramirez, Francisco C
AU - Fleischer, David E.
AU - Harris, Lucinda A.
AU - Lacy, Brian E.
AU - DiBaise, John K.
AU - Crowell, Michael D.
PY - 2014
Y1 - 2014
N2 - Functional dysphagia (FD) is characterized by the presence of dysphagia without evidence of mechanical esophageal obstruction, GERD, and histopathology-based esophageal motor disorders. Dysphagia is common in older patients; however, there is a paucity of information regarding the type and frequency of peristaltic abnormalities compared to younger patients. Based on recently validated criteria for classification of weak peristalsis using high-resolution manometry (HRM), we hypothesized that older patients with FD would have more peristaltic defects detected by HRM compared to younger FD patients. A retrospective review of our motility database yielded 65 patients that met inclusion criteria. Patients were divided into two groups based on age (younger: <70 years; older: ≥70 years). Patients were interviewed, completed a quality-of-life questionnaire, and underwent solid-state HRM. The two groups differed in age but in no other demographic characteristics, severity of dysphagia, or quality of life. Dyspeptic symptoms, including nausea (p < 0.001), early satiety (p = 0.01), bloating (p = 0.02), and belching (p = 0.01), were also more prevalent in younger FD patients. Older age was associated with weak peristalsis involving frequent failed peristalsis, small proximal peristaltic defects (2-5 cm), and large proximal peristaltic defects (>5 cm) (p < 0.001). The mean contraction amplitude was also lower in the older group (p < 0.05). These data support the hypothesis that older patients with FD have a higher frequency of peristaltic abnormalities on HRM compared to younger patients. Older age was associated with increased frequency of weak peristalsis with small and large peristaltic defects.
AB - Functional dysphagia (FD) is characterized by the presence of dysphagia without evidence of mechanical esophageal obstruction, GERD, and histopathology-based esophageal motor disorders. Dysphagia is common in older patients; however, there is a paucity of information regarding the type and frequency of peristaltic abnormalities compared to younger patients. Based on recently validated criteria for classification of weak peristalsis using high-resolution manometry (HRM), we hypothesized that older patients with FD would have more peristaltic defects detected by HRM compared to younger FD patients. A retrospective review of our motility database yielded 65 patients that met inclusion criteria. Patients were divided into two groups based on age (younger: <70 years; older: ≥70 years). Patients were interviewed, completed a quality-of-life questionnaire, and underwent solid-state HRM. The two groups differed in age but in no other demographic characteristics, severity of dysphagia, or quality of life. Dyspeptic symptoms, including nausea (p < 0.001), early satiety (p = 0.01), bloating (p = 0.02), and belching (p = 0.01), were also more prevalent in younger FD patients. Older age was associated with weak peristalsis involving frequent failed peristalsis, small proximal peristaltic defects (2-5 cm), and large proximal peristaltic defects (>5 cm) (p < 0.001). The mean contraction amplitude was also lower in the older group (p < 0.05). These data support the hypothesis that older patients with FD have a higher frequency of peristaltic abnormalities on HRM compared to younger patients. Older age was associated with increased frequency of weak peristalsis with small and large peristaltic defects.
KW - Age
KW - Esophageal pressure topography
KW - Functional dysphagia
KW - High-resolution manometry
KW - Nonobstructive dysphagia
UR - http://www.scopus.com/inward/record.url?scp=84906344355&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84906344355&partnerID=8YFLogxK
U2 - 10.1007/s00455-014-9540-y
DO - 10.1007/s00455-014-9540-y
M3 - Article
C2 - 24894375
AN - SCOPUS:84906344355
VL - 29
SP - 519
EP - 526
JO - Dysphagia
JF - Dysphagia
SN - 0179-051X
IS - 4
ER -