Anne-Laure Mallet1, Alain Ropert2, Guillaume Bouguen3, Laurent Siproudhis3, Dominique Boutroux4, Jean-François Bretagne1, Charlène Brochard5. 1. Gastroenterology Unit, CHRU Pontchaillou, University of Rennes 1, Rennes, France. 2. Digestive Disease Unit, CHRU Pontchaillou, University of Rennes 1, Rennes, France. 3. Gastroenterology Unit, CHRU Pontchaillou, University of Rennes 1, Rennes, France; INSERM U991, University of Rennes 1, Rennes, France; CIC 1414, INPHY, University of de Rennes 1, Rennes, France. 4. Gastroenterology Unit, CH Yves le Foll, Saint-Brieuc, France. 5. Gastroenterology Unit, CHRU Pontchaillou, University of Rennes 1, Rennes, France; Digestive Disease Unit, CHRU Pontchaillou, University of Rennes 1, Rennes, France; INSERM U991, University of Rennes 1, Rennes, France; CIC 1414, INPHY, University of de Rennes 1, Rennes, France. Electronic address: charlene.brochard@chu-rennes.fr.
Abstract
BACKGROUND: An association between acid gastro-oesophageal reflux disease (GERD) and Jackhammer oesophagus has been suggested. AIM: To assess the prevalence and characteristics of acid-GERD in Jackhammer oesophagus and the efficacy of proton pump inhibitors. METHODS: Data and outcomes of patients with Jackhammer oesophagus were assessed. Two groups were compared: (i) GERD, defined by endoscopic oesophagitis or by an increase in acid exposure time or by an acid-hypersensitive oesophagus and (ii) non-GERD defined by normal oesophageal acid exposure without acid-hypersensitive oesophagus. RESULTS: Among the 1994 high-resolution manometries performed, 44 Jackhammer oesophagus (2.2%) were included (sex ratio M/F: 19/25; median age: 66 [61-75] years). Nineteen patients (43.2%) had GERD, 16 (36.4%) had no GERD and 9 patients (20.4%) were undetermined. Dysphagia was the predominant symptom (37/43 (86%)). After a median follow-up of 25.3 months [9.6-31.4], dysphagia was improved in 22/36 (61.1%) patients. Dysphagia improvement as well as other symptoms improvement was not associated with GERD status or proton-pump inhibitors use. CONCLUSION: The prevalence of GERD is high among patients with Jackhammer oesophagus. The rates of symptom improvement in Jackhammer oesophagus were high regardless of the use of proton-pump inhibitors treatment or of the presence of GERD.
BACKGROUND: An association between acid gastro-oesophageal reflux disease (GERD) and Jackhammer oesophagus has been suggested. AIM: To assess the prevalence and characteristics of acid-GERD in Jackhammer oesophagus and the efficacy of proton pump inhibitors. METHODS: Data and outcomes of patients with Jackhammer oesophagus were assessed. Two groups were compared: (i) GERD, defined by endoscopic oesophagitis or by an increase in acid exposure time or by an acid-hypersensitive oesophagus and (ii) non-GERD defined by normal oesophageal acid exposure without acid-hypersensitive oesophagus. RESULTS: Among the 1994 high-resolution manometries performed, 44 Jackhammer oesophagus (2.2%) were included (sex ratio M/F: 19/25; median age: 66 [61-75] years). Nineteen patients (43.2%) had GERD, 16 (36.4%) had no GERD and 9 patients (20.4%) were undetermined. Dysphagia was the predominant symptom (37/43 (86%)). After a median follow-up of 25.3 months [9.6-31.4], dysphagia was improved in 22/36 (61.1%) patients. Dysphagia improvement as well as other symptoms improvement was not associated with GERD status or proton-pump inhibitors use. CONCLUSION: The prevalence of GERD is high among patients with Jackhammer oesophagus. The rates of symptom improvement in Jackhammer oesophagus were high regardless of the use of proton-pump inhibitors treatment or of the presence of GERD.
Authors: Matthew Woo; Andy Liu; Lynn Wilsack; Dorothy Li; Milli Gupta; Yasmin Nasser; Michelle Buresi; Michael Curley; Christopher N Andrews Journal: J Neurogastroenterol Motil Date: 2020-04-30 Impact factor: 4.924