Clinical and high-resolution manometric characteristics of secondary esophageal motility disorders

QI Hongyan; LIN Lin; ZHANG Qing; TANG Yurong

doi:10.16766/j.cnki.issn.1674-4152.004543

Volume 24 Issue 6

Jun. 2026

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Article Navigation > Chinese Journal of General Practice > 2026 > 24(6): 1014-1018

QI Hongyan, LIN Lin, ZHANG Qing, TANG Yurong. Clinical and high-resolution manometric characteristics of secondary esophageal motility disorders[J]. Chinese Journal of General Practice, 2026, 24(6): 1014-1018. doi: 10.16766/j.cnki.issn.1674-4152.004543

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QI Hongyan, LIN Lin, ZHANG Qing, TANG Yurong. Clinical and high-resolution manometric characteristics of secondary esophageal motility disorders[J]. Chinese Journal of General Practice, 2026, 24(6): 1014-1018. doi: 10.16766/j.cnki.issn.1674-4152.004543

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Clinical and high-resolution manometric characteristics of secondary esophageal motility disorders

doi: 10.16766/j.cnki.issn.1674-4152.004543

QI Hongyan¹
, LIN Lin¹
, ZHANG Qing²
, TANG Yurong^{1
,
,}

1.
Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China

Funds:

Y12023020

Received Date: 2025-08-14
Available Online: 2026-11-10

Abstract

Abstract

Objective Esophageal motility disorders (EMD) comprise a spectrum of conditions characterized by impairments in neuromuscular coordination leading to abnormal esophageal function. Etiologies are multifactorial, encompassing both primary idiopathic forms and disorders secondary to neurological or immune-mediated diseases. Notable secondary causes include Parkinson's disease, stroke and systemic sclerosis. These conditions disrupt esophageal motility through mechanisms such as autonomic denervation, smooth muscle dysfunction, and connective tissue fibrosis, resulting in compromised upper esophageal sphincter (UES) function, aberrant peristalsis, inadequate lower esophageal sphincter (LES) relaxation, or impaired bolus clearance. Clinical manifestations are heterogeneous and commonly include dysphagia, chest pain, and regurgitation. Severe cases may lead to significant morbidity, including aspiration pneumonia and malnutrition, profoundly diminishing quality of life. The nonspecific nature of symptoms complicates diagnosis, underscoring the necessity for objective physiological assessment. High-resolution esophageal manometry (HREM), utilizing a solid-state catheter with 36-64 pressure sensors, enabling detailed topographic visualization of esophageal pressure dynamics with high spatiotemporal resolution. It is currently the gold-standard modality for evaluating esophageal motor function, permitting precise characterization of UES and LES function, peristaltic vigor and propagation, and bolus transit patterns. This review synthesizes current evidence on the clinical and manometric features of EMD secondary to neurological and autoimmune conditions. Key manometric phenotypes include hypomotility and UES/LES dysfunction in Parkinson's disease, dyssynergia and uncoordinated motility following stroke, and hypocontractility with prevalent gastroesophageal reflux disease (GERD) in systemic sclerosis. We further elucidate the underlying pathophysiological mechanisms-such as neurodegeneration, autoimmunity, and fibrotic remodeling-and discuss the utility of HREM in tracking disease progression and evaluating treatment responses. Our objective is to enhance early recognition and inform holistic management strategies for these complex disorders.
- High-resolution esophageal manometry,
- Secondary esophageal motility disorders,
- Neurological/immune disorders,
- Dysphagia

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References(42)

References

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Clinical and high-resolution manometric characteristics of secondary esophageal motility disorders

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