Resident Physician University of Kentucky Lexington,, Kentucky
Objective: To review the literature regarding ineffective esophageal motility and characterize this disorder by reviewing demographics, comorbidities, and treatments.
Methods: Using PubMed and Web of Science, a review was conducted using the keyword “ineffective esophageal motility”. Titles and abstracts were reviewed. Studies were excluded if IEM was not the focus of the study. Study characteristics and outcome data of the included studies were extracted. Data was extracted from the Truven Database with initial criterion of a diagnosis of dysphagia, then narrowed to include patients with diagnoses of esophageal dysmotility and prior manometry. The demographics, comorbidities and treatments for these patients were compared with those with a diagnosis of dysphagia without dysmotility. Multinomial logistic regression was performed.
Results: 249 articles were identified after keyword search. After article assessment, accounting for overlap between databases, 55 articles were included. The majority were Gastroenterology literature, with little Otolaryngology literature on this topic identified. The content varied, including diagnostic criteria/methods, treatments, and common associations. From the Truven database, 1,989 patients had concurrent diagnoses of dysphagia and dysmotility with manometry. Multinomial logistic regression was performed to compare this cohort with patients with dysphagia and manometry without dysmotility. They had increased odds of concurrent diagnoses of gastroparesis, hiatal hernia, GERD, and systemic sclerosis, and increased odds of being treated with bethanechol and sumatriptan. These findings were statistically significant.
Conclusions: This study provides insight into the diagnosis of IEM, with a thorough review of the literature. Our results demonstrate some typical demographics, associated comorbidities, and treatments.