Gastroesophageal Reflux Disease Is Not Associated With Jackhammer Esophagus: A Case-control Study

Matthew Woo; Andy Liu; Lynn Wilsack; Dorothy Li; Milli Gupta; Yasmin Nasser; Michelle Buresi; Michael Curley; Christopher N Andrews

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자료유형: 학술저널

저자정보: Matthew Woo (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada) Andy Liu (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada) Lynn Wilsack (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada) Dorothy Li (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada) Milli Gupta (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada) Yasmin Nasser (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada) Michelle Buresi (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada) Michael Curley (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada) Christopher N Andrews (Division of Gastroenterology Cumming School of Medicine University of Calgary Calgary Canada)

저널정보: 대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.26 No.2

발행연도: 2020.1

수록면: 224 - 231 (8page)

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Background/AimsThe pathophysiology of jackhammer esophagus (JE) remains unknown but may be related to gastroesophageal reflux disease or medication use. We aim to determine if pathologic acid exposure or the use of specific classes of medications (based on the mechanism of action) is associated with JE. MethodsHigh-resolution manometry (HRM) studies from November 2013 to March 2019 with a diagnosis of JE were identified and compared to symptomatic control patients with normal HRM. Esophageal acid exposure and medication use were compared between groups. Multivariate regression analysis was performed to look for predictors of mean distal contractile integral. ResultsForty-two JE and 127 control patients were included in the study. Twenty-two (52%) JE and 82 (65%) control patients underwent both HRM and ambulatory pH monitoring. Two (9%) JE patients and 14 (17%) of controls had evidence of abnormal acid exposure (DeMeester score > 14.7); this difference was not significant (P = 0.290). Thirty-six (86%) JE and 127 (100%) control patients had complete medication lists. Significantly more JE patients were on long-acting beta agonists (LABA) (JE = 5, control = 4; P = 0.026) and calcium channel blockers (CCB) (JE = 5, control = 3; P = 0.014). Regular opioids (β = 0.298, P = 0.042), CCB (β = 0.308, P = 0.035), and inhaled anticholinergics (β = 0.361, P = 0.049) predicted mean distal contractile integral (R2 = 0.082, F = 4.8; P = 0.003). ConclusionsPathologic acid exposure does not appear to be associated with JE. JE patients had increased CCB and LABA use. The unexpected finding of increased LABA use warrants more investigation and may provide support for a cholinergic etiology of JE.

#Gastroesophageal reflux #Humans #Manometry

참고문헌 (37)

참고문헌 신청

Jia Y / 2016 / Frequency of jackhammer esophagus as the extreme phenotypes of esophageal hypercontractility based on the new chicago classification / J Clin Gastroenterol 50:615~618

Roman S / 2012 / Phenotypes and clinical context of hypercontractability in high resolution esophageal pressure topography(EPT) / Am J Gastroenterol 107:37~45

Herregods TV / 2017 / Jackhammer esophagus : observations on a european cohort / Neurogastroenterol Motil 29:e12975

Mallet AL / 2016 / Prevalence and characteristics of acid gastro-oesophageal reflux disease in jackhammer oesophagus / Dig Liver Dis 48:1136~1141

Kristo I / 2018 / Phenotypes of jackhammer esophagus in patients with typical symptoms of gastroesophageal reflux disease responsive to proton pump inhibitors / Sci Rep 8:9949

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