From the Gonczarowski Family Institute of Gastroenterology and Liver Diseases.
Internal Medicine Unit "A," Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel.
South Med J. 2023 Aug;116(8):701-706. doi: 10.14423/SMJ.0000000000001591.
Esophageal motility disorders (EMDs) are a known risk factor for esophageal candidiasis (EC), but this relation has not been described particularly well. We sought to evaluate the predictors of underlying EMDs in patients presenting with EC.
Cases of EC at a single medical center between 2010 and 2021 were identified retrospectively based on the code. Demographic, clinical, endoscopic, and manometric data were reviewed. The diagnosis of EC was based on typical endoscopic appearance.
In total, 130 EC patients were identified (mean age 69.5 ± 14.6; 66.2% male). Of these, 12 (9.2%) had an underlying EMD (11 cases of achalasia; 1 case of esophagogastric junction outflow obstruction). Five (41.7%) of these patients had previously been diagnosed as having an EMD, whereas 7 were newly diagnosed only after their presentation with EC. No significant differences were noted between those with or without EMDs in terms of demographics, medical comorbidities, or medication use. Patients with an EMD, however, were more likely to complain of dysphagia (91.7% vs 30.5%, < 0.001), and on endoscopy, they were more likely to have residual food in the esophagus, residual fluid in the esophagus, a dilated esophagus, and resistance to traversing the esophagogastric junction (all < 0.001). Sixty-one (46.9%) patients with EC died during follow-up (mean 58 months).
EMDs are present in approximately 10% of patients presenting with EC, with half being diagnosed only after presenting with EC. Similar to non-EC patients, patients with EC with dysphagia and the typical endoscopic findings of achalasia are more likely to have an EMD and warrant prompt manometric evaluation.
食管运动障碍（EMD）是食管念珠菌病（EC）的已知危险因素，但这种关系尚未得到很好的描述。我们旨在评估出现 EC 的患者中潜在 EMD 的预测因素。
回顾性地根据代码在 2010 年至 2021 年期间在一家医疗中心就诊的 EC 病例。审查了人口统计学、临床、内镜和测压数据。EC 的诊断基于典型的内镜表现。
共确定了 130 例 EC 患者（平均年龄 69.5 ± 14.6；66.2%为男性）。其中 12 例（9.2%）存在潜在的 EMD（11 例贲门失弛缓症；1 例食管胃交界处流出梗阻）。其中 5 例（41.7%）之前已被诊断为 EMD，而另外 7 例仅在出现 EC 后才被新诊断。在人口统计学、合并症或药物使用方面，有和没有 EMD 的患者之间没有显著差异。然而，有 EMD 的患者更可能出现吞咽困难（91.7% vs 30.5%， < 0.001），并且在内镜检查时，他们更可能有食管内残留食物、食管内残留液体、食管扩张和食管胃交界处阻力（均 < 0.001）。130 例 EC 患者中有 61 例（46.9%）在随访期间死亡（平均随访时间 58 个月）。
约 10%出现 EC 的患者存在 EMD，其中一半是在出现 EC 后才被诊断。与非 EC 患者相似，出现 EC 且有吞咽困难和贲门失弛缓典型内镜表现的患者更可能存在 EMD，需要及时进行测压评估。
