Mo1143 – Esophageal Motility Disorders in Eosinophilic Esophagitis

BACKGROUND AND AIMS: Eosinophilic Esophagitis (EoE) is a chronic immune/antigenmediated disorder, characterize by symptoms of esophageal dysfunction and eosinophilicinfiltration.EoE has been often associated with esophageal motility abnormalities, ranging from hypo-to hyper-contractile motility disorders.The aim of this study was to evaluate the incidence and clinical characteristics of esophageal motility disorders in EoE.MATERIAL AND METHODS: 97 consecutive patients (mean age 39, range 18-75yo, 20 F) with a diagnosis of EoE, assessed in our unit between 2012 to 2018, were included.The diagnosis was posed according to international criteria.Medical history, epidemiological and demographic data of these patients were collected.Among 97 patients, in 47 (48%) high resolution manometry (HRM) was not performed and were excluded from the study.Patients who undergo HRM, were studied by using the standardised international protocol and manometric diagnoses were carried out according to Chicago Classification 3.0.For the statistical analysis Fisher exact test was used.RESULTS: Among 50 patients included (mean age 41, range 20-75 yo, 42M), 26 (52%) showed normal manometric pattern.Between the EoE patients who showed a pathological pattern, 16 (67%) had hypocontractile disorders, and 8 (33%) had hypercontractile abnormalities.In particular, EoE patients with hypocontractile patterns had frequent failed peristalses (N=4), ineffective esophageal motility (N=6), fragmented peristalsis (N=4), absent peristalsis (N=2).Among EoE patients with hypercontractile patterns, we found achalasia type III (N=2), achalasia type II (N=2), achalasia type I (N=1), EGJ outflow obstruction (N=1), Jackhammer esophagus (N=1), and 1 distal esophageal spasm (N=1).The table below shows the characteristics of age, sex and response to PPI of patients in relation to their manometric pattern.There was no difference in terms of prevalence of motility abnormalities (p=0.49)nor a predominance of hypo / hyper contractile pattern (p=0.14), between PPI responsive and PPI non-responsive patients.Similarly, no difference in terms of motility abnormalities (p=1), nor a predominance of hypo / hyper contractile (p= 0.60) were found between females and males.Considering the mean age of the group (39yo), there was a different prevalence of motility abnormalities between younger and older patients, with greater frequency of pathological pattern in young patients (p= 0.045).However, there was no difference in terms of frequency of hypo-or hypercontractile disorders between young and old EoE patients (p= 0.49) CONCLUSION:This series shows that esophageal motility abnormalities are present in about half of EoE patients, especially in young subjects who showed a higher prevalence of hypocontractile disorders.A correlation with patient's gender or response to PPI therapy was not observed.Patients with normal motility vs Patients with motility disorders