Upper esophageal sphincter abnormalities on high-resolution esophageal manometry and treatment response of type II achalasia

Table 3 Upper esophageal sphincter abnormality subtypes based on high-resolution esophageal manometry diagnosis

		UES abnormality subtypes [n (%)]
		Hypertensive alone (n = 27)	Hypotensive alone (n = 42)	Impaired relaxation alone (n = 130)	Hypertensive with impaired relaxation (n = 15)	Hypotensive with impaired relaxation (n = 32)	P value
Gender	Male	15 (55.56)	19 (45.24)	65 (50.00)	7 (46.67)	14 (43.75)	0.889
	Female	12 (44.44)	23 (54.76)	65 (50.00)	8 (53.33)	18 (56.25)
Age (yr; mean ± SD)		42.81±11.11	50.79±12.43	47.35±13.51	42.53±10.91	54.31±13.49	0.003b
HREM results
Achalasia		0 (0.00)	1 (2.38)	5 (3.85)	3 (20.00)	3 (9.38)	0.027a
EGJ outflow obstruction		2 (7.41)	3 (7.14)	10 (7.69)	2 (13.33)	2 (6.25)	0.967
Contraction vigor	Failed	0 (0.00)	4 (9.52)	8 (6.15)	1 (6.67)	3 (9.38)	0.449
	Weak	10 (37.04)	9 (21.43)	29 (22.31)	4 (26.67)	4 (12.50)
	Normal	17 (62.96)	29 (69.05)	93 (71.54)	10 (66.67)	25 (78.13)
Distal esophageal spasm		0 (0.00)	0 (0.00)	3 (2.31)	0 (0.00)	1 (3.23)	0.82
Hypercontractile esophagus		0 (0.00)	0 (0.00)	0 (0.00)	0 (0.00)	0 (0.00)	-
Ineffective esophageal motility		3 (11.11)	9 (21.43)	21 (16.15)	5 (33.33)	3 (9.38)	0.256
Fragmented contraction		3 (11.11)	8 (19.05)	4 (3.08)	1 (6.67)	7 (21.88)	0.001b
Symptoms
Dysphagia		2 (7.41)	2 (4.76)	5 (3.85)	0 (0.00)	3 (9.38)	0.649
Heartburn		11 (40.74)	16 (38.10)	36 (27.69)	3 (20.00)	17 (53.13)	0.045a
Abdominal pain		6 (22.22)	12 (28.57)	38 (29.23)	7 (46.67)	9 (28.13)	0.595
Chest pain		2 (7.41)	8 (19.05)	19 (14.62)	2 (13.33)	9 (28.13)	0.183
Sour regurgitation		14 (51.85)	27 (64.29)	72 (55.38)	6 (40.00)	19 (59.38)	0.308
Ructus		16 (59.26)	16 (38.10)	66 (50.77)	8 (53.33)	13 (40.63)	0.088
Cough		3 (11.11)	8 (19.05)	7 (5.38)	1 (6.67)	4 (12.50)	0.383
Hiccup		1 (3.70)	5 (11.90)	11 (8.46)	0 (0.00)	1 (3.23)	0.241
Globus hystericus		6 (22.22)	15 (35.71)	49 (37.69)	5 (33.33)	13 (40.63)	0.238
Others		14 (51.85)	18 (42.86)	52 (40.00)	6 (40.00)	16 (50.00)	0.468

Level significance is indicated as follows:

^aP < 0.05;

^bP < 0.01. UES: Upper esophageal sphincter; HREM: High-resolution esophageal manometry; EGJ: Esophagogastric junction.