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Clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in Japan

BACKGROUND: Jackhammer esophagus (JE) is a hypercontractile esophageal motility disorder diagnosed using high-resolution manometry (HRM). We sought to determine the clinical presentation and therapeutic data of patients with JE in Japan. METHODS: The study included patients with JE, diagnosed throug...

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Autores principales: Hosaka, Hiroko, Kawami, Noriyuki, Manabe, Noriaki, Kuribayashi, Shiko, Sato, Hiroki, Funaki, Yasushi, Ayaki, Maki, Hara, Ken, Ueda, Chise, Matsumura, Tomoaki, Fujiwara, Yasuhiro, Wada, Masafumi, Kishino, Maiko, Yano, Fumiaki, Masaoka, Tatsuhiro, Ishimura, Norihisa, Akiyama, Junichi, Ochiai, Yorinari, Uraoka, Toshio, Iwakiri, Katsuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Nature Singapore 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166863/
https://www.ncbi.nlm.nih.gov/pubmed/35249162
http://dx.doi.org/10.1007/s10388-022-00916-7
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author Hosaka, Hiroko
Kawami, Noriyuki
Manabe, Noriaki
Kuribayashi, Shiko
Sato, Hiroki
Funaki, Yasushi
Ayaki, Maki
Hara, Ken
Ueda, Chise
Matsumura, Tomoaki
Fujiwara, Yasuhiro
Wada, Masafumi
Kishino, Maiko
Yano, Fumiaki
Masaoka, Tatsuhiro
Ishimura, Norihisa
Akiyama, Junichi
Ochiai, Yorinari
Uraoka, Toshio
Iwakiri, Katsuhiko
author_facet Hosaka, Hiroko
Kawami, Noriyuki
Manabe, Noriaki
Kuribayashi, Shiko
Sato, Hiroki
Funaki, Yasushi
Ayaki, Maki
Hara, Ken
Ueda, Chise
Matsumura, Tomoaki
Fujiwara, Yasuhiro
Wada, Masafumi
Kishino, Maiko
Yano, Fumiaki
Masaoka, Tatsuhiro
Ishimura, Norihisa
Akiyama, Junichi
Ochiai, Yorinari
Uraoka, Toshio
Iwakiri, Katsuhiko
author_sort Hosaka, Hiroko
collection PubMed
description BACKGROUND: Jackhammer esophagus (JE) is a hypercontractile esophageal motility disorder diagnosed using high-resolution manometry (HRM). We sought to determine the clinical presentation and therapeutic data of patients with JE in Japan. METHODS: The study included patients with JE, diagnosed through HRM performed for suspicious esophageal motility disorders. Demographics, esophagogastroduodenoscopy, radiology, and therapy data were collected from patient charts. RESULTS: Among the 4,412 HRM tests performed, 89 patients (61.6 ± 13.4 years; 64 males, 25 females) were diagnosed with JE (2.0%). Dysphagia was the most frequent symptom (80%), followed by chest pain (40%) and heartburn (25%). Esophagogastroduodenoscopy showed abnormal findings in 32% of patients: corkscrew/rosary beads appearance in 26%, narrowing in 11%. Eosinophilic infiltration (> 15 eosinophils/high power field) was diagnosed in 21%. Esophagography showed abnormal findings in 9% of the patients. For the initial therapy, 47 patients received medical treatment followed by peroral endoscopic myotomy (21 patients) and laparoscopic myotomy (two patients). Thirteen patients did not receive any treatment and 10 of those (77%) reported spontaneous resolution of symptoms. Patients who required invasive treatment experienced severe disability in their quality of life and greater maximal distal contractile integral than those who did not. CONCLUSIONS: HRM showed that the prevalence of JE was very low (2%). Esophagogastroduodenoscopy revealed some characteristic features of JE in patients. Some patients showed improvement of symptoms without invasive treatments. Follow-up with/without medical treatment should be considered before performing invasive treatment in patients whose distal contractile integral is relatively low and the quality of life is not impaired.
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spelling pubmed-91668632022-06-05 Clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in Japan Hosaka, Hiroko Kawami, Noriyuki Manabe, Noriaki Kuribayashi, Shiko Sato, Hiroki Funaki, Yasushi Ayaki, Maki Hara, Ken Ueda, Chise Matsumura, Tomoaki Fujiwara, Yasuhiro Wada, Masafumi Kishino, Maiko Yano, Fumiaki Masaoka, Tatsuhiro Ishimura, Norihisa Akiyama, Junichi Ochiai, Yorinari Uraoka, Toshio Iwakiri, Katsuhiko Esophagus Original Article BACKGROUND: Jackhammer esophagus (JE) is a hypercontractile esophageal motility disorder diagnosed using high-resolution manometry (HRM). We sought to determine the clinical presentation and therapeutic data of patients with JE in Japan. METHODS: The study included patients with JE, diagnosed through HRM performed for suspicious esophageal motility disorders. Demographics, esophagogastroduodenoscopy, radiology, and therapy data were collected from patient charts. RESULTS: Among the 4,412 HRM tests performed, 89 patients (61.6 ± 13.4 years; 64 males, 25 females) were diagnosed with JE (2.0%). Dysphagia was the most frequent symptom (80%), followed by chest pain (40%) and heartburn (25%). Esophagogastroduodenoscopy showed abnormal findings in 32% of patients: corkscrew/rosary beads appearance in 26%, narrowing in 11%. Eosinophilic infiltration (> 15 eosinophils/high power field) was diagnosed in 21%. Esophagography showed abnormal findings in 9% of the patients. For the initial therapy, 47 patients received medical treatment followed by peroral endoscopic myotomy (21 patients) and laparoscopic myotomy (two patients). Thirteen patients did not receive any treatment and 10 of those (77%) reported spontaneous resolution of symptoms. Patients who required invasive treatment experienced severe disability in their quality of life and greater maximal distal contractile integral than those who did not. CONCLUSIONS: HRM showed that the prevalence of JE was very low (2%). Esophagogastroduodenoscopy revealed some characteristic features of JE in patients. Some patients showed improvement of symptoms without invasive treatments. Follow-up with/without medical treatment should be considered before performing invasive treatment in patients whose distal contractile integral is relatively low and the quality of life is not impaired. Springer Nature Singapore 2022-03-06 2022 /pmc/articles/PMC9166863/ /pubmed/35249162 http://dx.doi.org/10.1007/s10388-022-00916-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Hosaka, Hiroko
Kawami, Noriyuki
Manabe, Noriaki
Kuribayashi, Shiko
Sato, Hiroki
Funaki, Yasushi
Ayaki, Maki
Hara, Ken
Ueda, Chise
Matsumura, Tomoaki
Fujiwara, Yasuhiro
Wada, Masafumi
Kishino, Maiko
Yano, Fumiaki
Masaoka, Tatsuhiro
Ishimura, Norihisa
Akiyama, Junichi
Ochiai, Yorinari
Uraoka, Toshio
Iwakiri, Katsuhiko
Clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in Japan
title Clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in Japan
title_full Clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in Japan
title_fullStr Clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in Japan
title_full_unstemmed Clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in Japan
title_short Clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in Japan
title_sort clinical presentation and therapeutic outcome of patients with jackhammer esophagus—a multicenter cohort study in japan
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166863/
https://www.ncbi.nlm.nih.gov/pubmed/35249162
http://dx.doi.org/10.1007/s10388-022-00916-7
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