Phenotypes of Jackhammer esophagus in patients with typical symptoms of gastroesophageal reflux disease responsive to proton pump inhibitors

Ivan Kristo, Katrin Schwameis, Svenja Maschke, Alexander Kainz, Erwin Rieder, Matthias Paireder, Gerd Jomrich, Sebastian F Schoppmann, Ivan Kristo, Katrin Schwameis, Svenja Maschke, Alexander Kainz, Erwin Rieder, Matthias Paireder, Gerd Jomrich, Sebastian F Schoppmann

Abstract

This trial was designed to assess the prevalence and characteristics of Jackhammer esophagus (JE), a novel hypercontractile disorder associated with progression to achalasia and limited outcomes following anti-reflux surgery in patients with typical symptoms of GERD and responsiveness to proton pump inhibitor (PPI) therapy. Consecutive patients, who were referred for surgical therapy because of PPI responsive typical symptoms of GERD, were prospectively assessed between January 2014 and May 2017. Patients diagnosed with JE subsequently underwent rigorous clinical screening including esophagogastroduodenoscopy (EGD), ambulatory pH impedance monitoring off PPI and a PPI trial. Out of 2443 evaluated patients, 37 (1.5%) subjects with a median age of 56.3 (51.6; 65) years were diagnosed with JE and left for final analysis. Extensive testing resulted in 16 (43.2%) GERD positive patients and 5 (13.9%) participants were observed to have an acid hypersensitive esophagus. There were no clinical parameters that differentiated phenotypes of JE. The prevalence of JE in patients with typical symptoms of GERD and response to PPI therapy is low. True GERD was diagnosed in less than half of this selected cohort, indicating the need for objective testing to stratify phenotypes of JE. (NCT03347903).

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study flow of patients with hypercontractile esophagus and involvement of gastroesophageal reflux disease and hypersensitivity JE…Jackhammer esophagus GERD…Gastroesophageal reflux disease

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Source: PubMed

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