Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Digestive and Liver Diseases, Columbia University, New York, New York, USA.
Neurogastroenterol Motil. 2024 Sep;36(9):e14839. doi: 10.1111/nmo.14839. Epub 2024 Jun 4.
Ineffective esophageal motility (IEM) is the most frequently diagnosed esophageal motility abnormality and characterized by diminished esophageal peristaltic vigor and frequent weak, absent, and/or fragmented peristalsis on high-resolution esophageal manometry. Despite its commonplace occurrence, this condition can often provoke uncertainty for both patients and clinicians. Although the diagnostic criteria used to define this condition has generally become more stringent over time, it is unclear whether the updated criteria result in a more precise clinical diagnosis. While IEM is often implicated with symptoms of dysphagia and gastroesophageal reflux disease, the strength of these associations remains unclear. In this review, we share a practical approach to IEM highlighting its definition and evolution over time, commonly associated clinical symptoms, and important management and treatment considerations. We also share the significance of this condition in patients undergoing evaluation for anti-reflux surgery and consideration for lung transplantation.
无效食管动力（IEM）是最常诊断的食管动力异常，其特征是食管蠕动活力减弱，高分辨率食管测压时常出现频繁的弱、缺如和/或片段性蠕动。尽管这种情况很常见，但它常常会给患者和临床医生带来不确定性。尽管用于定义这种情况的诊断标准随着时间的推移已经普遍变得更加严格，但尚不清楚更新的标准是否会导致更精确的临床诊断。虽然 IEM 常与吞咽困难和胃食管反流病的症状有关，但这些关联的强度仍不清楚。在这篇综述中，我们分享了一种实用的 IEM 方法，重点介绍了其随着时间的推移的定义和演变、常见的相关临床症状以及重要的管理和治疗注意事项。我们还分享了在接受反流手术评估和肺移植考虑的患者中这种情况的意义。
