Clinical features, endoscopic and manometric findings in patients with ineffective esophageal motility

Introduction: Ineffective esophageal motility (IEM) is an esophageal motility disorder (EMD) and the most prevalent abnormality routinely observed in esophageal manometry. Objectives: In this study, we investigated the clinical characteristics of IEM patients and the effects of proton pump inhibitors (PPI) and surgical treatments on their conditions. Patients and Methods: This cross-sectional study was conducted in Isfahan in 2019-2020 on 40 patients diagnosed with IEM. We collected patient demographic information (age, gender, previous medical history, medications, and duration of the current problem) and clinical manifestations (clinical symptoms of patients including dysphagia, heartburn, food and acid regurgitation, chest pain and belching) prior to and following PPI or surgical treatment. Results: Approximately 65% of patients presented with dysphagia and heartburn, 55% had food and acid regurgitation, 47.5% had belching, and 55% had chest pain. Post-treatment findings revealed that only the recurrence of food and acid regurgitation was significantly lower in the PPI treatment group than in the surgical group. Only dysphagia severity was statistically significant in the surgical group compared to other symptoms (P=0.042). In the PPI group, the severity of heartburn (P=0.007), dysphagia (P<0.001), food and acid regurgitation (P=0.007), and chest pain (P=0.027) decreased significantly compared to baseline. Conclusion: This study showed that the common clinical manifestations of IEM were dysphagia, heartburn, food and acid regurgitation, and belching. Moreover, treatment with PPI resulted in more significant improvements than surgical treatment.