esophageal motility disorders


Summary: Disorders affecting the motor function of the UPPER ESOPHAGEAL SPHINCTER; LOWER ESOPHAGEAL SPHINCTER; the ESOPHAGUS body, or a combination of these parts. The failure of the sphincters to maintain a tonic pressure may result in gastric reflux of food and acid into the esophagus (GASTROESOPHAGEAL REFLUX). Other disorders include hypermotility (spastic disorders) and markedly increased amplitude in contraction (nutcracker esophagus).

Top Publications

  1. Nguyen N, Holloway R. Recent developments in esophageal motor disorders. Curr Opin Gastroenterol. 2005;21:478-84 pubmed
    ..The usefulness of glucagon in relieving food bolus obstruction has been revisited in a retrospective study. These studies provide further information with which to more effectively manage esophageal motor disorders. ..
  2. Sjolund K, Bartosik I, Lindberg G, Scheja A, Wildt M, Akesson A. Small intestinal manometry in patients with systemic sclerosis. Eur J Gastroenterol Hepatol. 2005;17:1205-12 pubmed
    ..In eight out of 10 patients the manometric criteria for intestinal pseudo-obstruction were fulfilled, with a motility pattern consistent with both neuropathy and myopathy. The release of motility-regulating peptides was unaffected. ..
  3. Gregersen H, Pedersen J, Drewes A. Deterioration of muscle function in the human esophagus with age. Dig Dis Sci. 2008;53:3065-70 pubmed publisher
    ..Such changes may contribute to the high prevalence of reflux disease in elderly. ..
  4. Pandolfino J, Roman S. High-resolution manometry: an atlas of esophageal motility disorders and findings of GERD using esophageal pressure topography. Thorac Surg Clin. 2011;21:465-75 pubmed publisher
    ..This article provides an HRM-related atlas of esophageal motility disorders focused on dysphagia and gastroesophageal reflux disease (GERD)...
  5. Faraj J, Melander O, Sundkvist G, Olsson R, Thorsson O, Ekberg O, et al. Oesophageal dysmotility, delayed gastric emptying and gastrointestinal symptoms in patients with diabetes mellitus. Diabet Med. 2007;24:1235-9 pubmed
    ..Our findings indicate that the oesophagus and the stomach function as separate organs and that pathology in one does not necessarily mean pathology in the other. ..
  6. Rieder F, Biancani P, Harnett K, Yerian L, Falk G. Inflammatory mediators in gastroesophageal reflux disease: impact on esophageal motility, fibrosis, and carcinogenesis. Am J Physiol Gastrointest Liver Physiol. 2010;298:G571-81 pubmed publisher
    ..Novel findings regarding the pathophysiology of esophageal inflammation should enhance our understanding of GERD and its complications and provide new treatment insights. ..
  7. Bredenoord A, Fox M, Kahrilas P, Pandolfino J, Schwizer W, Smout A. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography. Neurogastroenterol Motil. 2012;24 Suppl 1:57-65 pubmed publisher
    ..The Chicago Classification is an algorithmic scheme for diagnosis of esophageal motility disorders from clinical EPT studies...
  8. Kim K, Kim G, Kim D, Wang S, Lee B, Lee J, et al. Is ineffective esophageal motility associated with gastropharyngeal reflux disease?. World J Gastroenterol. 2008;14:6030-5 pubmed
    ..There was no association between IEM and GPRD as well as between IEM and GERD. IEM alone cannot be considered as a definitive marker for reflux disease. ..
  9. Iascone C, Di Giulio E, Maffi C, Ruperto M. Use of radioisotopic esophageal transit in the assessment of patients with symptoms of reflux and non-specific esophageal motor disorders. Dis Esophagus. 2004;17:218-22 pubmed
    ..Radioisotopic esophageal clearance abnormalities are frequently observed in patients with reflux symptoms and are more likely to be associated to hypomotility disorders, i.e. nonpropagated motor activity or low-amplitude contractions...

More Information


  1. Dantas R, Aprile L. [Aging and esophageal motility in patients with gastroesophageal reflux disease]. Arq Gastroenterol. 2006;43:107-11 pubmed
    ..Patients with severe esophagitis had lower distal esophageal contraction amplitude than patients without esophagitis or with moderate esophagitis. There was no effect of aging on esophageal contractions. ..
  2. Ohlsson B, Melander O, Thorsson O, Olsson R, Ekberg O, Sundkvist G. Oesophageal dysmotility, delayed gastric emptying and autonomic neuropathy correlate to disturbed glucose homeostasis. Diabetologia. 2006;49:2010-4 pubmed
    ..Low oesophageal peristaltic speed was associated with slow gastric emptying whereas parasympathetic neuropathy was associated with increased glucose variations. ..
  3. Kastelik J, Redington A, Aziz I, Buckton G, Smith C, Dakkak M, et al. Abnormal oesophageal motility in patients with chronic cough. Thorax. 2003;58:699-702 pubmed
    ..Oesophageal dysmotility may therefore be important in the pathogenesis of cough in these patients. ..
  4. Zerbib F, Guisset O, Lamouliatte H, Quinton A, Galmiche J, Tunon de Lara J. Effects of bronchial obstruction on lower esophageal sphincter motility and gastroesophageal reflux in patients with asthma. Am J Respir Crit Care Med. 2002;166:1206-11 pubmed
    ..These results support the belief that, in asthma, bronchial obstruction may be responsible for reflux or may aggravate reflux through a mechanism that remains to be further clarified. ..
  5. Spechler S, Castell D. Classification of oesophageal motility abnormalities. Gut. 2001;49:145-51 pubmed
    ..This should facilitate and improve comparisons among patients and studies. However, it is important to emphasise that fulfilment of the proposed criteria does not establish the clinical importance of the motility abnormalities. ..
  6. Simren M, Silny J, Holloway R, Tack J, Janssens J, Sifrim D. Relevance of ineffective oesophageal motility during oesophageal acid clearance. Gut. 2003;52:784-90 pubmed
    ..Ineffective oesophageal motility has little effect on oesophageal clearance during upright acid reflux. With supine reflux, only severe IOM is associated with prolonged oesophageal clearance. ..
  7. Vinjirayer E, Gonzalez B, Brensinger C, Bracy N, Obelmejias R, Katzka D, et al. Ineffective motility is not a marker for gastroesophageal reflux disease. Am J Gastroenterol. 2003;98:771-6 pubmed
    ..26). IEM does not stand alone as a significant marker for the presence of GERD in general or supraesophageal reflux disease in particular. ..
  8. Pustorino S, Calipari G, Foti M, Germanotta G, Consolo P, Guerrisi O, et al. [Esophageal transit and esophageal motility disorders in patients with nontoxic goiter and recurrent dysphagia]. Recenti Prog Med. 2002;93:235-9 pubmed
    ..It is concluded that esophageal transit delay, early in the upper and prolonged in the lower part of the esophagus, represents the main findings of the esophageal dysfunction in the patients with nontoxic goiter and dysphagia...
  9. Champion J, Delise N, Hunt T. Myenteric plexus in spastic motility disorders. J Gastrointest Surg. 2001;5:514-6 pubmed
    ..There was no significant correlation in our series between the presence of ganglia and an elevated lower esophageal sphincter pressure in spastic motility disorders. ..
  10. Richter J. Oesophageal motility disorders. Lancet. 2001;358:823-8 pubmed
    ..Secondary oesophageal motility disorders can be caused by collagen vascular diseases, diabetes, Chagas' disease, amyloidosis, alcoholism, myxo-oedema, multiple sclerosis, idiopathic pseudo-obstruction, or the ageing process. ..
  11. Schlottmann F, Patti M. Primary Esophageal Motility Disorders: Beyond Achalasia. Int J Mol Sci. 2017;18: pubmed publisher
    ..However, symptoms such as dysphagia, regurgitation and chest pain can be caused by other esophageal motility disorders. The Chicago classification introduced new manometric parameters and better defined esophageal ..
  12. Sadreameli S, McGrath Morrow S. Respiratory Care of Infants and Children with Congenital Tracheo-Oesophageal Fistula and Oesophageal Atresia. Paediatr Respir Rev. 2016;17:16-23 pubmed publisher
  13. Krarup A, Liao D, Gregersen H, Drewes A, Hejazi R, McCallum R, et al. Nonspecific motility disorders, irritable esophagus, and chest pain. Ann N Y Acad Sci. 2013;1300:96-109 pubmed publisher
  14. Jalil S, Sperandio M, Tutuian R, Castell D. Are 10 wet swallows an appropriate sample of esophageal motility? Yes and no. J Clin Gastroenterol. 2004;38:30-4 pubmed
    ..846) and between the first 10 and all 20 swallows (kappa = 0.965). Ten wet swallows are sufficient for making a manometric diagnosis, because additional swallows are likely to change the diagnosis in only 2% of patients. ..
  15. Kopelman Y, Triadafilopoulos G. Endoscopy in the diagnosis and management of motility disorders. Dig Dis Sci. 2011;56:635-54 pubmed publisher
    ..This review aims to guide the appropriate indications for the use of endoscopy in diagnosing and treating functional GI and motility disorders and serve as a bridge and a forum of exchange between endoscopists and motility specialists. ..
  16. Sung H, Kim J, Lee K, Kim Y, Song I, Chung S, et al. The prevalence and patterns of pharyngoesophageal dysmotility in patients with early stage Parkinson's disease. Mov Disord. 2010;25:2361-8 pubmed publisher
  17. Wong W, Wong B. Noncardiac chest pain: an Asian view. Gastroenterol Clin North Am. 2004;33:125-33 pubmed
    ..GERD is the most common etiology. PPI therapy is an attractive alternative to other invasive diagnostic tests for NCCP and is equally effective for the Asian population. ..
  18. Uskudar O, Dagli U, Asil M, Yol S, Sasmaz N. Epiphrenic diverticulum with abnormal manometry: a case report. Turk J Gastroenterol. 2004;15:108-11 pubmed
    ..There is a high prevalence of esophageal motility abnormalities in patients with epiphrenic diverticula, though they are very rare, and, as in this case, may be difficult to classify...
  19. Taglieri N, Galie N, Marzocchi A. Acute hand ischemia after radial intervention in patient with CREST-associated pulmonary hypertension: successful treatment with manual thromboaspiration. J Invasive Cardiol. 2013;25:89-91 pubmed
    ..This case shows that radial occlusion, one of the most common and usually asymptomatic complications following transradial cardiac catheterization, may cause severe hand ischemia in patients with small-vessel inflammatory disease. ..
  20. Ibrahim A, Al Malki T, Hamza A, Bahnassy A. Congenital esophageal stenosis associated with esophageal atresia: new concepts. Pediatr Surg Int. 2007;23:533-7 pubmed
    ..CES should be considered in the etiology of anastomotic stricture. Taking a surgical specimen routinely from the tip of the LEP during primary esophageal repair for histologic studies is highly recommended. ..
  21. Smout A. Advances in esophageal motor disorders. Curr Opin Gastroenterol. 2008;24:485-9 pubmed publisher
    ..The spastic esophageal motility disorders nutcracker esophagus and diffuse esophageal spasm may coexist with gastroesophageal reflux disease, ..
  22. Landreneau R, Del Pino M, Santos R. Management of paraesophageal hernias. Surg Clin North Am. 2005;85:411-32 pubmed
    ..No one approach can universally apply to this patient population if optimal therapy, quality of life, and overall survival are to be optimized. ..
  23. Liu Z, Wang K, Duan L, Xia Z, Xu Z, Ge Y, et al. [Comparison of clinical features and high-resolution esophageal motility characteristics between esophagogastric junction outflow obstruction and type ? achalasia patients]. Zhonghua Yi Xue Za Zhi. 2016;96:1435-40 pubmed publisher
    ..Further study of the pathophysiological characteristics of Eoo patients may provide more evidence to elucidate the pathogenesis of achalasia. ..
  24. FakhreYaseri H, FakhreYaseri A, Baradaran Moghaddam A, Soltani Arabshhi S. Relationship between esophageal clinical symptoms and manometry findings in patients with esophageal motility disorders: a cross-sectional study. Med J Islam Repub Iran. 2015;29:271 pubmed
    ..Clinical symptoms are not reliable enough to discriminate between EMDs. Clinical symptoms can, however, discriminate between normal findings and EMDs, especially achalasia. ..
  25. Hannig C, Wuttge Hannig A, Rummeny E. [Esophageal motility disorders]. Radiologe. 2007;47:123-36 pubmed
    ..b>Esophageal motility disorders are subdivided by radiologic and manometric criteria into primary, secondary, and nonclassifiable ..
  26. Kim S, Meleca R. Irreversible hydrocolloid: an unusual presentation of esophageal obstruction. Ear Nose Throat J. 2007;86:167-8 pubmed
    ..We present just such a case, and we discuss our preferred method of removing foreign bodies from the cervical esophagus. ..
  27. Oridate N, Takeda H, Mesuda Y, Nishizawa N, Furuta Y, Asaka M, et al. Evaluation of upper abdominal symptoms using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease in patients with laryngopharyngeal reflux symptoms. J Gastroenterol. 2008;43:519-23 pubmed publisher
    ..The pretreatment frequency of dysmotility-like symptoms, but not of acid reflux-related symptoms, might be a predictor of patient response to acid-suppression therapy. ..
  28. Boland K, Abdul Hussein M, Tutuian R, Castell D. Characteristics of Consecutive Esophageal Motility Diagnoses After a Decade of Change. J Clin Gastroenterol. 2016;50:301-6 pubmed publisher
    ..100%). This study brings to light the increase in prevalence of IEM. In addition, it suggests that the hypertensive LES and poorly relaxing LES may each affect bolus transit in about half of these patients. ..
  29. Tutuian R, Castell D. Multichannel intraluminal impedance: general principles and technical issues. Gastrointest Endosc Clin N Am. 2005;15:257-64 pubmed
  30. Xiao Y, Kahrilas P, Nicodème F, Lin Z, Roman S, Pandolfino J. Lack of correlation between HRM metrics and symptoms during the manometric protocol. Am J Gastroenterol. 2014;109:521-6 pubmed publisher
    ..Other factors beyond circular muscle contraction patterns should be explored as possible causes of symptom generation. ..
  31. D Alessio M, Rakita S, Bloomston M, Chambers C, Zervos E, Goldin S, et al. Esophagography predicts favorable outcomes after laparoscopic Nissen fundoplication for patients with esophageal dysmotility. J Am Coll Surg. 2005;201:335-42 pubmed
    ..Preoperative esophagography predicts successful outcomes after laparoscopic Nissen fundoplication for patients with manometric esophageal dysmotility. ..
  32. Hansi N, Thoua N, Carulli M, Chakravarty K, Lal S, Smyth A, et al. Consensus best practice pathway of the UK scleroderma study group: gastrointestinal manifestations of systemic sclerosis. Clin Exp Rheumatol. 2014;32:S-214-21 pubmed
    ..The algorithms are a useful tool for clinicians, which we hope, will be a point of reference and highlight the need for further research in these areas. ..
  33. Cruiziat C, Roman S, Robert M, Espalieu P, Laville M, Poncet G, et al. High resolution esophageal manometry evaluation in symptomatic patients after gastric banding for morbid obesity. Dig Liver Dis. 2011;43:116-20 pubmed publisher
    ..These symptoms could be secondary to esophageal motility disorders. Our aim was to assess esophageal motility and clearance in symptomatic LAGB patients using high ..
  34. Sood A, Gambhir S, Sewatkar A, Deswal S, Sarswat V, Kumar R. Esophageal motor disorder diagnosed by esophageal transit scintigraphy. Clin Nucl Med. 2004;29:768-9 pubmed
  35. Li K, Zheng S, Xiao X, Wang Q, Zhou Y, Chen L. The structural characteristics and expression of neuropeptides in the esophagus of patients with congenital esophageal atresia and tracheoesophageal fistula. J Pediatr Surg. 2007;42:1433-8 pubmed
  36. Pendleton H, Ekman R, Olsson R, Ekberg O, Ohlsson B. Motilin concentrations in relation to gastro intestinal dysmotility in diabetes mellitus. Eur J Intern Med. 2009;20:654-9 pubmed publisher
    ..842, p=0.017, respectively). Gastric emptying did not influence motilin concentrations. Plasma motilin concentrations vary with abnormalities of oesophageal motility in diabetics, but not with abnormalities of gastric emptying. ..
  37. Sharata A, Kurian A, Dunst C, Bhayani N, Reavis K, Swanstrom L. Peroral endoscopic myotomy (POEM) is safe and effective in the setting of prior endoscopic intervention. J Gastrointest Surg. 2013;17:1188-92 pubmed publisher
    ..This study involves 40 consecutive patients undergoing POEM. POEM was performed for esophageal motility disorders, including achalasia, nutcracker with nonrelaxing lower esophageal sphincter (LES), hypertensive lower ..
  38. Karoui S, Sami Mourali M, Zouiten L, Matri S, Djebbi S, Boubaker J, et al. [Esophageal abnormalities in patients with chest pain and normal coronary angiograms]. Tunis Med. 2006;84:705-10 pubmed
    ..33 - 12.50]). Gastroesophageal reflux disease is the most common esophageal abnormality n; patients with noncardiac chest pain. In the absence of regurgitations, 24-hour esophageal pH monitoring must be the first test to be performed. ..
  39. Richter J, Pandolfino J, Vela M, Kahrilas P, Lacy B, Ganz R, et al. Utilization of wireless pH monitoring technologies: a summary of the proceedings from the esophageal diagnostic working group. Dis Esophagus. 2013;26:755-65 pubmed publisher
  40. Lin Z, Pandolfino J, Xiao Y, Carlson D, Bidari K, Escobar G, et al. Localizing the contractile deceleration point (CDP) in patients with abnormal esophageal pressure topography. Neurogastroenterol Motil. 2012;24:972-5 pubmed publisher
    ..Optimal automated CDP localization was achieved in both normal and a spectrum of abnormal motility using the tML method with the added stipulation that the CDP be restricted to within the distal 3 cm of the EGJ at rest. ..
  41. Zaninotto G, Portale G, Costantini M, Merigliano S, Guirroli E, Rizzetto C, et al. Long-term outcome of operated and unoperated epiphrenic diverticula. J Gastrointest Surg. 2008;12:1485-90 pubmed publisher
    ..Even in the long-term, unoperated patients do not die of their ED, though a better subjective symptom outcome is reported by operated patients. A non-interventional policy can safely be adopted in cases of small, mildly symptomatic ED. ..
  42. Chan W, Haroian L, Gyawali C. Value of preoperative esophageal function studies before laparoscopic antireflux surgery. Surg Endosc. 2011;25:2943-9 pubmed publisher
    ..Physiologic testing remains important in the preoperative evaluation of patients being considered for LARS. ..
  43. Soto Pérez J, Sobrino Cossio S, Higgins P, Comuzzie A, Vargas Romero J, Reding Bernal A, et al. Distal esophageal hypercontractility is related to abnormal acid exposure. Arch Med Res. 2011;42:104-9 pubmed publisher
    ..Meanwhile, acid exposure was higher in younger patients and hypercontractility was more frequent in older subjects. The former group may benefit more from proton pump inhibitors and the latter from visceral analgesics or possibly both. ..
  44. Zhang J, Cui P, Lv D, Yao S, Xu Y, Yang Z. Gastroesophageal reflux in cirrhotic patients without esophageal varices. World J Gastroenterol. 2011;17:1753-8 pubmed publisher
    ..10% and 28.21% in patients with liver cirrhosis without EV. Cirrhotic patients without EV presented esophageal motor disorders and mixed acid and bile reflux was the main pattern; the cirrhosis itself was an important causative factor. ..
  45. Ghosh S, Pandolfino J, Kwiatek M, Kahrilas P. Oesophageal peristaltic transition zone defects: real but few and far between. Neurogastroenterol Motil. 2008;20:1283-90 pubmed publisher
    ..8%). Although far less common than distal peristaltic or OGJ abnormailites, TZ defects may be related to dysphagia in a minority of patients (<4% in this series) and should be considered a distinct oesophageal motility disorder. ..
  46. Achem S. Treatment of spastic esophageal motility disorders. Gastroenterol Clin North Am. 2004;33:107-24 pubmed
    ..Recent trials with Botox, nitric oxide derivatives, and SSRIs offer promising results. Rigorous study design that includes large placebo-controlled trials is needed in this area. ..
  47. Chen H, Rampazzo A, Gharb B, Wong M, Mardini S, Chen H, et al. Motility differences in free colon and free jejunum flaps for reconstruction of the cervical esophagus. Plast Reconstr Surg. 2008;122:1410-6 pubmed publisher
    ..Free colon and ileocolon flaps should be reserved for very proximal oropharyngeal defects and when simultaneous voice reconstruction is desired. ..
  48. Ciriza de Los Ríos C, García Menéndez L, Díez Hernández A, Fernández Eroles A, Vega Fernández A, Enguix Armada A. Motility abnormalities in esophageal body in GERD: are they truly related to reflux?. J Clin Gastroenterol. 2005;39:220-3 pubmed
    ..Esophageal manometric abnormalities should be considered cautiously before considering a motor disorder as a consequence of abnormal reflux. ..
  49. Kraichely R, Arora A, Murray J. Opiate-induced oesophageal dysmotility. Aliment Pharmacol Ther. 2010;31:601-6 pubmed publisher
    ..These data suggest that the oesophagus is susceptible to the effects of opiates and care must be taken before ascribing dysphagia to a primary oesophageal motility disorder in patients taking opiates. ..
  50. De Lagausie P, Bonnard A, Schultz A, Van den Abbeel T, Bellaiche M, Hartmann J, et al. Reflux in esophageal atresia, tracheoesophageal cleft, and esophagocoloplasty: Bianchi's procedure as an alternative approach. J Pediatr Surg. 2005;40:666-9 pubmed
    ..The long-term safety of this operation remains to be determined especially regarding the consequences of a gastrointestinal Roux-en-Y loop procedure. ..
  51. Karoui S, Serghini M, Ghouma M, Zouiten L, Matri S, Ben Ghorbel I, et al. [Esophageal motility abnormalities in systemic sclerosis: frequency and predictive factors]. Tunis Med. 2009;87:511-5 pubmed
    ..Esophageal motor abnormalities are frequent in patients with systemic sclerosis. They can be specific and nonspecific. Esophageal manometry should be systematically performed among these patients, even in the absence of dysphagia. ..
  52. Sugiura M, Ohmae Y, Mogitate M, Kimura Y, Makino N, Kato T. [Relationship between globus sensation and esophageal clearance abnormalities in an elderly group]. Nihon Jibiinkoka Gakkai Kaiho. 2006;109:524-9 pubmed
    ..Videopharyngoesophageal examination in the prone position may be an easy and valuable method for evaluating the function of esophageal clearance. ..
  53. Cersosimo M, Benarroch E. Neural control of the gastrointestinal tract: implications for Parkinson disease. Mov Disord. 2008;23:1065-75 pubmed publisher
    ..This early involvement provides insights into the pathophysiology of gastrointestinal dysmotility in this disorder and may constitute an important step in the etiopathogenesis of Lewy body disease. ..