INEFFECTIVE OESOPHAGEAL MOTILITY IN PATIENTS WITH DYSPHAGIA AND GASTRO-OESOPHAGEAL REFLUX DISEASE
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Oesophageal hypomotility is prevalent in 30-50% of the patients with GORD and/or dysphagia. Despite
advances in diagnosing oesophageal hypomotility, there is no established therapy for this group of
patients.
I studied the effect of Azithromycin in patients with Ineffective oesophageal motility (IOM). I assessed
the value of stimulation tests during oesophageal manometry (multiple rapid swallows, bread swallows
and swallows with abdominal compression), in identifying the patients who might benefit from
prokinetic treatment with Azithromycin.
Effect of stimulation tests in healthy subjects was investigated and normal ranges for oesophageal
response to these tests was established. Characteristics of normal proximal oesophageal motility were
defined and the role of proximal oesophageal hypomotility in symptomatology of the patients with IOM
investigated. Effect of azithromycin on IOM and on the symptoms of these patients were studied in a
double blind placebo controlled parallel design study. The predictive value of the stimulation tests in
identifying the responders to azithromycin therapy was evaluated.
Stimulation tests proved to be effective on inducing stronger motility response in oesophageal body and
this effect was reproducible. Weak proximal oesophageal motility in patients with IOM is associated
with reflux symptoms presentation. Azithromycin can convert IOM to normal motility in a subgroup of
patients. Multiple rapid swallowing as well as swallows with abdominal compression can moderately
predict the response to prokinetic therapy with Azithromycin.
Authors
Jafari, JafarCollections
- Theses [3711]