Prevalence of Esophageal Motility Disorders Among Patients Presenting with Dysphagia

Authors

  • Zrar Hussein Rasul Hawler gastroenterology and Hepatology center ,Rizgary Teaching Hospital ,Hawler,Kurdistan region,Iraq
  • Mohammed Omer Mohammed Branch of Clinical Science, College of Medicine, University of Sulaimani, Sulaimani, Iraq
  • Blund Sirwan Abdulla Hawler gastroenterology and Hepatology center ,Rizgary Teaching Hospital ,Hawler,Kurdistan region,Iraq

DOI:

https://doi.org/10.21271/ZJPAS.38.1.6

Keywords:

Dysphagia, Esophageal motility disorders, Manometry, EGD

Abstract

Esophageal motility disorders impair normal peristalsis of the esophagus and often lead to dysphagia and represent a clinically significant problem with increasing recognition worldwide. These disorders are commonly encountered in patients presenting with esophageal symptoms, yet their true prevalence remains underreported, particularly in regions where diagnostic facilities are limited including Erbil, Kurdistan region-Iraq. Understanding their burden is essential for improving diagnostic accuracy and patient outcomes. The study aims to clarify the prevalence of oesophagal motility disorders among participants with dysphagia and to study the sensitivity of the diagnostic methods. Additionally, to illustrate demographic, clinical, lifestyle, and psychosocial characteristics of esophageal dysmotility (ED) patients  with confirmed esophageal motility disorders. A case-series study was conducted from June 2024 to June 2025 at the Hawler Center for Gastroenterology and Hepatology. A total of 113 adult participants with dysphagia underwent a standardized diagnostic workup including esophageal gastroduodenoscopy (EGD), barium swallow and manometry. Participants with confirmed esophageal motility disorders on manometry were classified as a patient group, while participants without motility disorders served as controls. Data on demographics, medical history, clinical symptoms, lifestyle habits, and psychosocial impact were collected via structured questionnaires. Among participants with dysphagia (113), manometry identified oesophagal motility disorders in 67 (59.3%) of cases, with 22 EGJ outflow obstruction (19.46%) and 21 achalasia (18.58%) being the most common findings. Regurgitation (n=47, 70.15%), vomiting (n=45, 67.16%), and weight loss (n=51, 76.11%) were significantly more prevalent in ED group compared to controls. Alcohol use was lower in ED group, while smoking and hot drink intake were similar. Psychosocial burden, including emotional distress (n=47), impaired quality of life (n=49), and altered eating behaviors (n=34), was significantly greater (p-value <0.0001) in ED group. More than half of ED patients presented with dysphagia are manifested in esophageal dysmotility. Manometry being the gold standard in diagnosis of this group. Lifestyles were more prevalent in such patients. Dysphagia due to motility disorders is associated with older age, specific gastrointestinal symptoms, and a significant psychosocial impact.

 

References

BALABRAM, S. K., TESSARO, L., ASTOLFO, M. E. A., SPONCHIADO, P. A. I., BOGUSZ JUNIOR, S. & MANIGLIA, B. C. 2025. Development of NADES-Annatto Seed Extract for Enhancing 3D Printed Food Designed for Dysphagia Patients. Foods, 14.

DELSHAD, S. D., ALMARIO, C. V., CHEY, W. D. & SPIEGEL, B. M. R. 2020. Prevalence of Gastroesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms. Gastroenterology, 158, 1250-1261.e2.

DENZER, U. W., MÜLLER, M., KREUSER, N., THIEME, R., HOFFMEISTER, A., FEISTHAMMEL, J., NIEBISCH, S. & GOCKEL, I. 2023. [Therapy of esophageal motility disorders]. Z Gastroenterol, 61, 183-197.

GONZÁLEZ-FERNÁNDEZ, M. & DANIELS, S. K. 2008. Dysphagia in stroke and neurologic disease. Physical Medicine and Rehabilitation Clinics, 19, 867-888.

GONZÁLEZ-FERNÁNDEZ, M., OTTENSTEIN, L., ATANELOV, L. & CHRISTIAN, A. B. 2013. Dysphagia after stroke: an overview. Current physical medicine and rehabilitation reports, 1, 187-196.

GYAWALI, C. P. & PENAGINI, R. 2021. Clinical usefulness of esophageal high resolution manometry and adjunctive tests: An update. Dig Liver Dis, 53, 1373-1380.

HOSHIKAWA, Y. & IWAKIRI, K. 2024. Esophageal Motility Disorders: Diagnosis and Treatment Strategies. Digestion, 105, 11-17.

KAHRILAS, P. J., BREDENOORD, A. J., FOX, M., GYAWALI, C. P., ROMAN, S., SMOUT, A. J. & PANDOLFINO, J. E. 2015. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil, 27, 160-74.

KRISHNAMURTHY, C., HILDEN, K., PETERSON, K. A., MATTEK, N., ADLER, D. G. & FANG, J. C. 2012. Endoscopic findings in patients presenting with dysphagia: analysis of a national endoscopy database. Dysphagia, 27, 101-5.

LE, K. H. N., LOW, E. E. & YADLAPATI, R. 2023. Evaluation of Esophageal Dysphagia in Elderly Patients. Curr Gastroenterol Rep, 25, 146-159.

LEONIDOU, E., IOANNOU, M., MAVROMMATIS, P. & MOUZAROU, A. 2023. A case report of a patient with heart failure with preserved ejection fraction presented as dysphagia. ESC Heart Failure, 10, 2707-2710.

LIU, L. W. C., ANDREWS, C. N., ARMSTRONG, D., DIAMANT, N., JAFFER, N., LAZARESCU, A., LI, M., MARTINO, R., PATERSON, W., LEONTIADIS, G. I. & TSE, F. 2018. Clinical Practice Guidelines for the Assessment of Uninvestigated Esophageal Dysphagia. J Can Assoc Gastroenterol, 1, 5-19.

MAHAJAN, R., KULKARNI, R. & STOOPLER, E. T. 2022. Gastroesophageal reflux disease and oral health: A narrative review. Spec Care Dentist, 42, 555-564.

MASCARENHAS, A., MENDO, R., O'NEILL, C., FRANCO, A. R., MENDES, R., SIMÃO, I. & RODRIGUES, J. P. 2023. Current Approach to Dysphagia: A Review Focusing on Esophageal Motility Disorders and Their Treatment. GE Port J Gastroenterol, 30, 403-413.

MASSEY, B. T. 2007. Esophageal motor and sensory disorders: presentation, evaluation, and treatment. Gastroenterol Clin North Am, 36, 553-75, viii.

MOHAMMED, M. O., SALIM, B. F. & RAMADHAN, A. A. 2015. Esophageal manometry among patients with dysphagia referred to Kurdistan center for gastroenterology and hepatology. AMJ (Advanced Medical Journal), 1, 34-42.

PAN, J., CEN, L., CHEN, W., YU, C., LI, Y. & SHEN, Z. 2019. Alcohol Consumption and the Risk of Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis. Alcohol Alcohol, 54, 62-69.

PANT, A., LEE, A. Y., KARYAPPA, R., LEE, C. P., AN, J., HASHIMOTO, M., TAN, U.-X., WONG, G., CHUA, C. K. & ZHANG, Y. 2021. 3D food printing of fresh vegetables using food hydrocolloids for dysphagic patients. Food Hydrocolloids, 114, 106546.

SANAGAPALLI, S., PLUMB, A., LORD, R. V. & SWEIS, R. 2023. How to effectively use and interpret the barium swallow: Current role in esophageal dysphagia. Neurogastroenterol Motil, 35, e14605.

SHEN, Z., HOU, Y., HUERMAN, A. & MA, A. 2022. Patients with dysphagia: How to supply nutrition through non-tube feeding. Frontiers in Nutrition, 9, 1060630.

TARASZEWSKA, A. 2021. Risk factors for gastroesophageal reflux disease symptoms related to lifestyle and diet. Rocz Panstw Zakl Hig, 72, 21-28.

VAEZI, M. F., PANDOLFINO, J. E. & VELA, M. F. 2013. ACG clinical guideline: diagnosis and management of achalasia. Am J Gastroenterol, 108, 1238-49; quiz 1250.

VASIREDDY, A. R., LEGGETT, C. L. & KAMBOJ, A. K. 2025. Esophageal Motility Disorders: A Concise Review on Classification, Diagnosis, and Management. Mayo Clin Proc, 100, 332-339.

VOULGARIS, T., ALEXOPOULOS, T., VLACHOGIANNAKOS, J., KAMBEROGLOU, D., PAPATHEODORIDIS, G. & KARAMANOLIS, G. 2025. Diagnostic approach to patients with suspected motility disorders: one size does not fit all. Ann Gastroenterol, 38, 12-19.

WILKINS, T., GILLIES, R. A., THOMAS, A. M. & WAGNER, P. J. 2007. The prevalence of dysphagia in primary care patients: a HamesNet Research Network study. J Am Board Fam Med, 20, 144-50.

WILKINSON, J. M. & HALLAND, M. 2020. Esophageal Motility Disorders. Am Fam Physician, 102, 291-296.

XU, J. Q., GENG, Z. H., LIU, Z. Q., YAO, L., ZHANG, Z. C., ZHONG, Y. S., ZHANG, Y. Q., HU, J. W., CAI, M. Y., YAO, L. Q., LI, Q. L. & ZHOU, P. H. 2023. Landscape of Psychological Profiles in Patients With Esophageal Achalasia. Clin Transl Gastroenterol, 14, e00613.

YADLAPATI, R., KAHRILAS, P. J., FOX, M. R., BREDENOORD, A. J., PRAKASH GYAWALI, C., ROMAN, S., BABAEI, A., MITTAL, R. K., ROMMEL, N., SAVARINO, E., SIFRIM, D., SMOUT, A., VAEZI, M. F., ZERBIB, F., AKIYAMA, J., BHATIA, S., BOR, S., CARLSON, D. A., CHEN, J. W., CISTERNAS, D., COCK, C., COSS-ADAME, E., DE BORTOLI, N., DEFILIPPI, C., FASS, R., GHOSHAL, U. C., GONLACHANVIT, S., HANI, A., HEBBARD, G. S., WOOK JUNG, K., KATZ, P., KATZKA, D. A., KHAN, A., KOHN, G. P., LAZARESCU, A., LENGLINER, J., MITTAL, S. K., OMARI, T., PARK, M. I., PENAGINI, R., POHL, D., RICHTER, J. E., SERRA, J., SWEIS, R., TACK, J., TATUM, R. P., TUTUIAN, R., VELA, M. F., WONG, R. K., WU, J. C., XIAO, Y. & PANDOLFINO, J. E. 2021. Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0(©). Neurogastroenterol Motil, 33, e14058.

Published

2026-02-28

How to Cite

Zrar Hussein Rasul, Mohammed Omer Mohammed, & Abdulla, B. S. (2026). Prevalence of Esophageal Motility Disorders Among Patients Presenting with Dysphagia. Zanco Journal of Pure and Applied Sciences, 38(1), 73–82. https://doi.org/10.21271/ZJPAS.38.1.6

Issue

Section

Biology, Chemistry and Medical Researches