Sa1201 High-Resolution Esophageal Manometry (HREM) Patterns in Patients With Undifferentiated Connective Tissue Disorder (UCTD) Presenting With Dysphagia

Abstract

G A A b st ra ct s SAP (Wuesten method). Patient groups were identified based on APM: 1: acid-sensitive (positive SAP/normal AET), 2: abnormal acid exposure with symptom association (positive SAP/elevated AET), 3: abnormal acid exposure without symptom association (negative SAP/ elevated AET), and 4: no reflux (negative SAP/normal AET). Patient demographics, esophageal motor pattern (normal, hypomotility, hypermotility), and reflux profile were recorded. Univariate and multivariate analyses were performed using Chi-square test and logistic regression. Results: 445 patients (age 46.1±1.2 yr, 63.4%F) were included in the study. Acid sensitive patients were more consistently female (81.8%) in comparison to other groups (Table, p<0.01). As expected, the likelihood of disrupted peristalsis (hypomotility) was highest in patients with elevated AET/positive SAP, compared to other two groups (Table, p=0.02). In contrast, acid sensitive subjects had the highest proportions of normal motility patterns. Hypermotility patterns were most frequent in symptomatic patients with no reflux parameters. Both groups with abnormal acid exposure (+SAP/+AET and -SAP/+AET) performed similarly on HRM. On multivariate analysis of positive SAP patients, female sex (OR=3.89, p=0.004), younger age (β=-0.038, p=0.02), and normal motility (OR=2.29, p= 0.03) were independently associated with normal acid exposure, while hypomotility (OR= 0.38, p=0.04) was inversely related. Conclusions: Symptomatic patients with intact peristalsis may clear refluxate more efficiently, resulting in normal acid exposure. HRM may help predict abnormal acid exposure among patients with GERD symptoms. Further study is warranted to better understand symptom generation in GERD patients.