Esophageal motor disorders in older adults: experience with highresolution esophageal manometry at a referral center in Colombia
DOI:
https://doi.org/10.47892/rgp.2025.454.2010Keywords:
Aged, Manometry, Esophageal Motility Disorders, DysphagiaAbstract
Introduction: Advanced age is associated with a greater prevalence of oesophageal motor disorders due to increased lower oesophageal sphincter (LES) pressure and decreased peristaltic vigour. Secondary peristalsis is particularly affected by age, which may be related to increased oesophageal dysmotility in older adults. Objectives: To describe the most common oesophageal disorders in older adults undergoing high-resolution oesophageal manometry (HREM) according to the Chicago Classification V4.0. Materials and methods: An observational, descriptive, retrospective, cross-sectional study was conducted at San Ignacio University Hospital. Patients over 65 years of age who underwent HREM for various reasons between 2020 and 2025 were included. Results: Total number of patients included, age and age range. A total of 177 patients aged 65 years or older, with an age range of 68- 76 years, were included. The main indication for HREM was dysphagia, present in 49.7% of patients, followed by reflux symptoms in 39%. The most frequent pathological manometric diagnosis was inconclusive outlet obstruction (14.1%), followed by ineffective oesophageal motility (9.6%) and achalasia (5.1%). A manometric diagnosis of ineffective oesophageal motility was made in 17.1% of patients with erosive gastro-oesophageal reflux disease (GERD). Conclusion: Older adults are more likely to have esophageal dysmotility, and outflow tract obstruction disorders are the most frequently identified in this population.
Downloads
Metrics
References
Yadlapati R, Kahrilas PJ, Fox MR, Bredenoord AJ, Prakash Gyawali C, Roman S, et al. Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0©. Neurogastroenterol Motil. 2021 Jan;33(1):e14058. doi: 10.1111/nmo.14058.
Abdelghani A, Ibrahim A, El-Sayed ES, El Sherbiny M, Al-Badry A. Esophageal motility disorders in symptomatic patients and its relation to age. BMC Gastroenterol. 2023;23(1):69. doi: 10.1186/s12876-023-02709-3.
Pasta A, Facchini C, Calabrese F, Bodini G, De Bortoli N, Furnari M, et al. Esophageal motor disorders across ages: A retrospective multicentric analysis. J Am Geriatr Soc. 2024;72(9):2782-91. doi: 10.1111/jgs.19068.
Gidwaney NG, Bajpai M, Chokhavatia SS. Gastrointestinal Dysmotility in the Elderly. J Clin Gastroenterol. 2016;50(10):819- 27. doi: 10.1097/MCG.0000000000000650.
Steele CM, Greenwood C, Ens I, Robertson C, SeidmanCarlson R. Mealtime Difficulties in a Home for the Aged: Not Just Dysphagia. Dysphagia. 1997;12(1):43-50. doi: 10.1007/ pl00009517.
Besanko LK. Lower esophageal sphincter relaxation is impaired in older patients with dysphagia. World J Gastroenterol. 2011;17(10):1326-31. doi: 10.3748/wjg.v17.i10.1326.
Ribeiro AC, Klingler PJ, Hinder RA, DeVault K. Esophageal Manometry: A Comparison of Findings in Younger and Older Patients. Am J Gastroenterol. 1998;93(5):706-10. doi: 10.1111/j.1572-0241.1998.210_a.x.
Arndorfer D, Pandolfino JE, Kahrilas PJ, Carlson DA. Age Affects Esophageal Secondary Peristalsis More Than Primary as Assessed by FLIP Panometry and High-resolution Manometry. Clin Gastroenterol Hepatol. 2024;22(12):2532-2534.e1. doi: 10.1016/j.cgh.2024.06.001.
Vaezi MF, Pandolfino JE, Yadlapati RH, Greer KB, Kavitt RT. ACG Clinical Guidelines: Diagnosis and Management of Achalasia. Am J Gastroenterol. 2020;115(9):1393-1411. doi: 10.14309/ ajg.0000000000000731.
Wade PR, Cowen T. Neurodegeneration: a key factor in the ageing gut. Neurogastroenterol Motil. 2004;16 Suppl 1:19-23. doi: 10.1111/j.1743-3150.2004.00469.x.
Gyawali CP, Yadlapati R, Fass R, Katzka D, Pandolfino J, Savarino E, et al. Updates to the modern diagnosis of GERD: Lyon consensus 2.0. Gut. 2024;73(2):361-371. doi: 10.1136/ gutjnl-2023-330616.
Dao HV, Matsumura T, Kaneko T, Takahashi S, Tokunaga M, Oura H, et al. Impact of ineffective esophageal motility on chemical clearance in patients with gastroesophageal reflux symptoms. Dis Esophagus. 2020;33(9):doaa026. doi: 10.1093/ dote/doaa026.
Diener U, Patti MG, Molena D, Fisichella PM, Way LW. Esophageal dysmotility and gastroesophageal reflux disease. J Gastrointest Surg. 2001;5(3):260-5. doi: 10.1016/s1091- 255x(01)80046-9.
Li L, Gao H, Zhang C, Tu J, Geng X, Wang J, et al. Diagnostic value of X-ray, endoscopy, and high-resolution manometry for hiatal hernia: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2020;35(1):13-18. doi: 10.1111/jgh.14758.
Weijenborg PW, van Hoeij FB, Smout AJPM, Bredenoord AJ. Accuracy of hiatal hernia detection with esophageal high-resolution manometry. Neurogastroenterol Motil. 2015;27(2):293-9. doi: 10.1111/nmo.12507.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Albis Hani, Valentina Dávila, Manuela Ossa, Jesús Villamizar, Raúl A. Cañadas, Fredy Ávila, Fernando Yun
This work is licensed under a Creative Commons Attribution 4.0 International License.
Revista de Gastroenterología del Perú by Sociedad Peruana de Gastroenterología del Perú is licensed under a Licencia Creative Commons Atribución 4.0 Internacional..
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
2022 