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- W2913996959 abstract "Introduction: Jackhammer esophagus (JE) is defined by the Chicago Classification v3.0 as normal median integrated relaxation pressure (IRP) over ten liquid swallows with a distal contractile integral (DCI) >8,000 mmHg-s-cm on at least two swallows. This diagnosis is relatively new, with the most current definition being established in 2014. The forerunner of this diagnosis, nutcracker esophagus, has been associated with the predominant symptom of non-cardiac chest pain (NCCP). The aim of our study was to further characterize JE symptoms and relationship with bolus transit (BT). Methods: A retrospective chart review was performed of motility studies from 2011-2016, a period of transition in reporting from conventional to high-resolution manometry (HRM) in our laboratory. Studies with a reported diagnosis of JE, hypercontractile esophagus, nutcracker, EGJ outflow obstruction, or hypertensive LES were reread using Chicago Classification v3.0, and were included if they met criteria for JE. Conventional line tracings and studies with less than ten interpretable liquid swallows were excluded. Unpaired t-tests were used for analysis (p≤0.05). Results: One hundred forty-two studies were identified with the above diagnoses. After excluding 84 studies, 58 remained for analysis and 17 were found to have JE (29%). The mean age was 54 (28-75), 5 (29%) were males and 12 (71%) were females. The primary indications were NCCP (5), dysphagia (8), and other causes (cough, heartburn, or regurgitation) (4). The mean DCIs were 17245 mmHg-s-cm (NCCP), 14669 mmHg-s-cm (dysphagia), and 11148 mmHg-s-cm (other causes). The mean DCIs were compared: NCCP vs dysphagia (P=0.41), and NCCP vs other causes (P=0.05). Fifteen (88%) had normal BT for both liquid and viscous swallows. Conclusion: JE is an uncommon diagnosis in need of further characterization. In our small sample size, dysphagia is the most common symptom followed by NCCP. This is contrary to its predecessor, nutcracker esophagus, where NCCP is found in up to 48% of patients. Those with NCCP have a trend towards a higher DCI compared to patients with dysphagia, albeit not significantly. The DCI in NCCP patients compared to other causes implies that a higher DCI correlates with NCCP. While JE is a major motility abnormality, BT appeared to be normal. More data are needed to further elucidate the genesis of symptoms and how they relate to the degree of contractility." @default.
- W2913996959 created "2019-02-21" @default.
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- W2913996959 date "2017-10-01" @default.
- W2913996959 modified "2023-10-14" @default.
- W2913996959 title "Jackhammer Esophagus: Symptom Presentation, Associated Distal Contractile Integral, and Assessment of Bolus Transit" @default.
- W2913996959 doi "https://doi.org/10.14309/00000434-201710001-00382" @default.
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