Raquel R Mendes, José Pedro Rodrigues, Inês Simão, Helena Lima, Tiago Guedes, Sílvia Barrias, Mara Sarmento Costa, Paulo Souto, João Carlos Silva, João Correia, Bárbara Morão, Joana Revés, Carina Leal, José Dias Curto, Rui Tato Marinho, Miguel Mascarenhas Saraiva
{"title":"非阻塞性食管吞咽困难的现实管理：一项前瞻性多中心葡萄牙队列分析。","authors":"Raquel R Mendes, José Pedro Rodrigues, Inês Simão, Helena Lima, Tiago Guedes, Sílvia Barrias, Mara Sarmento Costa, Paulo Souto, João Carlos Silva, João Correia, Bárbara Morão, Joana Revés, Carina Leal, José Dias Curto, Rui Tato Marinho, Miguel Mascarenhas Saraiva","doi":"10.1177/17562848251345340","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Nonobstructive esophageal dysphagia (NOD) is a common benign condition that significantly impacts quality of life. Management requires a motility-focused approach and consideration for concomitant comorbidities such as gastroesophageal reflux, visceral hypersensitivity, and psychological factors. Currently, esophagogastric junction (EGJ) outflow disorders have the most studied and effective treatments. Data on patient-reported dysphagia and quality of life in this population, and their evolution over time and treatment, are scarce.</p><p><strong>Objective: </strong>This study aims to evaluate the real-world management and behavior of NOD, focusing on motility profiles and the implementation of specific treatments.</p><p><strong>Design: </strong>This is a multicenter prospective observational study that follows the management and evolution of NOD in a Portuguese cohort for 6 months, focusing on dysphagia and quality of life, to evaluate its clinical behavior.</p><p><strong>Methods: </strong>Dysphagia and quality of life were assessed in 195 patients using validated patient-reported questionnaires at baseline and follow-up.</p><p><strong>Results: </strong>From 195 patients, 61% (<i>n</i> = 119) were female, with a mean age of 61 (SD 15) years. According to Chicago classification 4.0, 32.3% (<i>n</i> = 63) had EGJ outflow disorders, 12.8% (<i>n</i> = 25) spastic disorders, 16.4% (<i>n</i> = 32) hypomotile disorders, 35.9% (<i>n</i> = 70) normal motility, and 2.6% (<i>n</i> = 5) were inconclusive. At baseline, the mean PROMIS Gastrointestinal Disrupted Swallowing (PDS) T-score, EQ-5D-3L, and Visual Analog Scale (VAS) scores were 61.7 (SD 7.4), 0.61 (SD 0.26), and 69 (SD 18), respectively. Overall, at 6 months, there were significant improvements in the Eckardt, PDS, and EQ-5D-3L scores, with no difference in VAS. In EGJ disorders, myotomy significantly improved all measurements. In the remaining subgroups, a favorable evolution of dysphagia was observed, without differences between treated and untreated patients.</p><p><strong>Conclusion: </strong>NOD tends to follow a benign course. Apart from achalasia, which has the most defined treatments with documented benefits, decisions for the remaining motility profiles should follow a comprehensive and personalized approach.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251345340"},"PeriodicalIF":3.4000,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205188/pdf/","citationCount":"0","resultStr":"{\"title\":\"Real-life management of nonobstructive esophageal dysphagia: analysis of a prospective multicentric Portuguese cohort.\",\"authors\":\"Raquel R Mendes, José Pedro Rodrigues, Inês Simão, Helena Lima, Tiago Guedes, Sílvia Barrias, Mara Sarmento Costa, Paulo Souto, João Carlos Silva, João Correia, Bárbara Morão, Joana Revés, Carina Leal, José Dias Curto, Rui Tato Marinho, Miguel Mascarenhas Saraiva\",\"doi\":\"10.1177/17562848251345340\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Nonobstructive esophageal dysphagia (NOD) is a common benign condition that significantly impacts quality of life. Management requires a motility-focused approach and consideration for concomitant comorbidities such as gastroesophageal reflux, visceral hypersensitivity, and psychological factors. Currently, esophagogastric junction (EGJ) outflow disorders have the most studied and effective treatments. Data on patient-reported dysphagia and quality of life in this population, and their evolution over time and treatment, are scarce.</p><p><strong>Objective: </strong>This study aims to evaluate the real-world management and behavior of NOD, focusing on motility profiles and the implementation of specific treatments.</p><p><strong>Design: </strong>This is a multicenter prospective observational study that follows the management and evolution of NOD in a Portuguese cohort for 6 months, focusing on dysphagia and quality of life, to evaluate its clinical behavior.</p><p><strong>Methods: </strong>Dysphagia and quality of life were assessed in 195 patients using validated patient-reported questionnaires at baseline and follow-up.</p><p><strong>Results: </strong>From 195 patients, 61% (<i>n</i> = 119) were female, with a mean age of 61 (SD 15) years. According to Chicago classification 4.0, 32.3% (<i>n</i> = 63) had EGJ outflow disorders, 12.8% (<i>n</i> = 25) spastic disorders, 16.4% (<i>n</i> = 32) hypomotile disorders, 35.9% (<i>n</i> = 70) normal motility, and 2.6% (<i>n</i> = 5) were inconclusive. At baseline, the mean PROMIS Gastrointestinal Disrupted Swallowing (PDS) T-score, EQ-5D-3L, and Visual Analog Scale (VAS) scores were 61.7 (SD 7.4), 0.61 (SD 0.26), and 69 (SD 18), respectively. Overall, at 6 months, there were significant improvements in the Eckardt, PDS, and EQ-5D-3L scores, with no difference in VAS. In EGJ disorders, myotomy significantly improved all measurements. In the remaining subgroups, a favorable evolution of dysphagia was observed, without differences between treated and untreated patients.</p><p><strong>Conclusion: </strong>NOD tends to follow a benign course. Apart from achalasia, which has the most defined treatments with documented benefits, decisions for the remaining motility profiles should follow a comprehensive and personalized approach.</p>\",\"PeriodicalId\":48770,\"journal\":{\"name\":\"Therapeutic Advances in Gastroenterology\",\"volume\":\"18 \",\"pages\":\"17562848251345340\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-06-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205188/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Gastroenterology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17562848251345340\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562848251345340","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Real-life management of nonobstructive esophageal dysphagia: analysis of a prospective multicentric Portuguese cohort.
Background: Nonobstructive esophageal dysphagia (NOD) is a common benign condition that significantly impacts quality of life. Management requires a motility-focused approach and consideration for concomitant comorbidities such as gastroesophageal reflux, visceral hypersensitivity, and psychological factors. Currently, esophagogastric junction (EGJ) outflow disorders have the most studied and effective treatments. Data on patient-reported dysphagia and quality of life in this population, and their evolution over time and treatment, are scarce.
Objective: This study aims to evaluate the real-world management and behavior of NOD, focusing on motility profiles and the implementation of specific treatments.
Design: This is a multicenter prospective observational study that follows the management and evolution of NOD in a Portuguese cohort for 6 months, focusing on dysphagia and quality of life, to evaluate its clinical behavior.
Methods: Dysphagia and quality of life were assessed in 195 patients using validated patient-reported questionnaires at baseline and follow-up.
Results: From 195 patients, 61% (n = 119) were female, with a mean age of 61 (SD 15) years. According to Chicago classification 4.0, 32.3% (n = 63) had EGJ outflow disorders, 12.8% (n = 25) spastic disorders, 16.4% (n = 32) hypomotile disorders, 35.9% (n = 70) normal motility, and 2.6% (n = 5) were inconclusive. At baseline, the mean PROMIS Gastrointestinal Disrupted Swallowing (PDS) T-score, EQ-5D-3L, and Visual Analog Scale (VAS) scores were 61.7 (SD 7.4), 0.61 (SD 0.26), and 69 (SD 18), respectively. Overall, at 6 months, there were significant improvements in the Eckardt, PDS, and EQ-5D-3L scores, with no difference in VAS. In EGJ disorders, myotomy significantly improved all measurements. In the remaining subgroups, a favorable evolution of dysphagia was observed, without differences between treated and untreated patients.
Conclusion: NOD tends to follow a benign course. Apart from achalasia, which has the most defined treatments with documented benefits, decisions for the remaining motility profiles should follow a comprehensive and personalized approach.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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