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Turkish Journal of Gastroenterology
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Published Online: July 27, 2026
This work is licensed under a Creative Commons Attribution 4.0 International License.
Harun Erdal
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Yusuf Coşkun
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Deniz Armağan Deniz
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Burak Birsoy
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Yusuf Üstün
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Erdal, H., Coşkun, Y., Deniz, D. A., Birsoy, B., & Üstün, Y. (2026). Ineffective Esophageal Motility with and Without Abnormal Acid Exposure: Clinical, Endoscopic, and Manometric Features. Turkish Journal of Gastroenterology. https://doi.org/10.5152/tjg.2026.25627
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Abstract
Background/Aims: Ineffective esophageal motility (IEM) is the most common esophageal motility disorder. Reflux is common in patients with IEM. The relationship between IEM and gastroesophageal reflux disease is not fully understood. The current study evaluated the associations between clinical, endoscopic, and manometric characteristics and acid exposure in patients with IEM.
Materials and Methods: The authors prospectively enrolled patients diagnosed with IEM who underwent high-resolution manometry according to the Chicago classification, version 4.0. Patients were classified into pathological and physiological reflux groups based on multichannel intraluminal impedance-pH ( MII-pH) monitoring results. Clinical, endoscopic, manometric, and MII-pH parameters were compared between the 2 groups.
Results: Of the 69 patients, 49 (71%) had pathological reflux and 20 (29%) had physiological reflux. The most frequent symptoms were heartburn, regurgitation, and dysphagia. No significant differences were observed between the 2 groups in demographic, clinical, or endoscopic characteristics. Among the manometric metrics, mean lower esophageal sphincter pressure and esophagogastric junction (EGJ) morphology differed significantly between the 2 groups (P = .017 and P = .046, respectively). All MII‑pH metrics, except weak acid reflux episodes and nonacid reflux episodes, differed significantly between the groups (P <.05).
Conclusion: Acid exposure did not affect symptoms in patients with IEM. In addition to impaired esophageal body contractility, impaired esophageal clearance and EGJ barrier dysfunction may contribute to acid exposure.
Cite this article as: Erdal H, Coşkun Y, Deniz DA, Birsoy B, Üstün Y. Ineffective esophageal motility with and without abnormal acid exposure: Clinical, endoscopic, and manometric features. Turk J Gastroenterol. Published online July 27, 2026. doi: 10.5152/tjg.2026.25627.
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Article Info
History
Published Online
July 27, 2026
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Affiliations
Harun Erdal
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Yusuf Coşkun
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Deniz Armağan Deniz
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Burak Birsoy
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Yusuf Üstün
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Cite this Article
Erdal, H., Coşkun, Y., Deniz, D. A., Birsoy, B., & Üstün, Y. (2026). Ineffective Esophageal Motility with and Without Abnormal Acid Exposure: Clinical, Endoscopic, and Manometric Features. Turkish Journal of Gastroenterology. https://doi.org/10.5152/tjg.2026.25627
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