Normal study or minor motor disorders detected on high-resolution oesophageal manometry – are they relevant?

Introduction
The clinical significance of normal motility or minor peristaltic disorders, noted on esophageal manometry, in symptomatic patients is unclear.

Aim
To determine the clinical presentation, response to treatment, and outcomes at 2-year follow-up in symptomatic patients with normal manometry and minor peristaltic disorders.

Material and methods
This prospective cohort study included patients between 18 and 80 years old. Patients with previous upper gastrointestinal surgery, prior dilation or myotomy, and major motility disorders or EGJ outflow obstruction as per CC v 3.0 were excluded. The cohort was divided into two groups: normal manometry (Gp1) and minor peristaltic defects (Gp2). Study subjects were contacted for follow-up at 6, 12, and 24 months from the date of initial high-resolution oesophageal manometry study. Details of drug use, symptom control, and requirement of anti-reflux procedures in both groups were obtained.

Results
Fifty-six patients (median age: 42.3 years, males 72%) formed the study cohort: Gp1 – 35 (62.5%) and Gp2 – 21 (37.5%). The patients in the two groups were comparable in terms of symptoms (p = 0.94) and treatment (p = 0.15) at presentation. On follow-up, the majority of the cases (76.8%) reported improvement in symptoms at 2 years. None required anti-reflux procedures. There were no significant differences in the symptom profile and drug use in patients in the two groups at various time periods.

Conclusions
Patients with normal and minor oesophageal motor function abnormalities do not worsen over time.