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Gastroesophageal Reflux Disease Is Not Associated With Jackhammer Esophagus: A Case-control Study

Matthew Woo ; Andy Liu ; Lynn Wilsack ; Dorothy Li ; Milli Gupta ; Yasmin Nasser ; Michelle Buresi ; Michael Curley ; Christopher N Andrews

Journal of neurogastroenterology and motility, 2020-04, Vol.26 (2), p.224-231 [Periódico revisado por pares]

대한소화기기능성질환·운동학회

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  • Título:
    Gastroesophageal Reflux Disease Is Not Associated With Jackhammer Esophagus: A Case-control Study
  • Autor: Matthew Woo ; Andy Liu ; Lynn Wilsack ; Dorothy Li ; Milli Gupta ; Yasmin Nasser ; Michelle Buresi ; Michael Curley ; Christopher N Andrews
  • Assuntos: Gastroesophageal reflux ; Humans ; Manometry
  • É parte de: Journal of neurogastroenterology and motility, 2020-04, Vol.26 (2), p.224-231
  • Notas: The Korean Society of Gastrointestinal Motility
  • Descrição: Background/Aims The pathophysiology of jackhammer esophagus (JE) remains unknown but may be related to gastroesophageal reflux disease or medication use. We aim to determine if pathologic acid exposure or the use of specific classes of medications (based on the mechanism of action) is associated with JE. Methods High-resolution manometry (HRM) studies from November 2013 to March 2019 with a diagnosis of JE were identified and compared to symptomatic control patients with normal HRM. Esophageal acid exposure and medication use were compared between groups. Multivariate regression analysis was performed to look for predictors of mean distal contractile integral. Results Forty-two JE and 127 control patients were included in the study. Twenty-two (52%) JE and 82 (65%) control patients underwent both HRM and ambulatory pH monitoring. Two (9%) JE patients and 14 (17%) of controls had evidence of abnormal acid exposure (DeMeester score > 14.7); this difference was not significant (P = 0.290). Thirty-six (86%) JE and 127 (100%) control patients had complete medication lists. Significantly more JE patients were on long-acting beta agonists (LABA) (JE = 5, control = 4; P = 0.026) and calcium channel blockers (CCB) (JE = 5, control = 3; P = 0.014). Regular opioids (β = 0.298, P = 0.042), CCB (β = 0.308, P = 0.035), and inhaled anticholinergics (β = 0.361, P = 0.049) predicted mean distal contractile integral (R 2 = 0.082, F = 4.8; P = 0.003). Conclusions Pathologic acid exposure does not appear to be associated with JE. JE patients had increased CCB and LABA use. The unexpected finding of increased LABA use warrants more investigation and may provide support for a cholinergic etiology of JE. (J Neurogastroenterol Motil 2020;26:224-231)
  • Editor: 대한소화기기능성질환·운동학회
  • Idioma: Coreano
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