PD03.01. Assessment of Esophageal Wall Motion in Jackhammer Esophagus Using Transnasal Endoscopic Ultrasonography

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ID: 326209
2026
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Ranked #385 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Benign Disease: Esophageal Function and Motility Background Jackhammer esophagus (JE) is an esophageal motility disorder characterized by excessive esophageal body contractions, leading to symptoms such as non-cardiac chest pain and dysphagia. While high-resolution manometry (HRM) is the diagnostic gold standard for evaluating esophageal muscle contractions, it has limitations in directly assessing esophageal wall distensibility. We have newly developed a novel method esophageal wall motion (EUS-EM) via transnasal endoscopic ultrasonography (EUS). This study aimed to clarify the relationship between muscle layer changes and impaired wall distensibility in JE patients, using this technique. Methods The study included 20 patients with JE (diagnosed via Chicago Classification Ver.4.0; 14 males, mean age 63.3) and 10 controls (4 males, mean age 43.6). All participants underwent both EUS-EM and HRM on the same day. During EUS-EM, patients were instructed to swallow 20 ml of oral rehydration solution. The movements of esophageal wall during swallowing were recorded using a transnasal endoscope equipped with a 20 MHz ultrasound probe. We evaluated the contractility index (CI), wall distensibility, and the correlation between the muscle layer thickness and the esophageal lumen area. Results All procedures were completed successfully without adverse events. While the CI showed no significant difference between the two groups, esophageal wall distensibility was significantly reduced in JE patients compared to controls (Fig. 1). JE patients exhibited significantly thicker muscle layer thickness across all phases. Additionally, comparison of esophageal lumen area during distension showed significantly smaller in JE patients, and a significant correlation was observed between increased muscle layer thickness and decreased esophageal lumen area (Fig. 2). Conclusion Transnasal EUS revealed that impaired esophageal wall distensibility, potentially driven by muscle layer hypertrophy, is a key pathophysiological mechanism of dysphagia in JE patients.
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Authors Emiko Bukeo, Noriaki Manabe, Kenta Hamada, Shoichiro Hirata, Takako Etani, Maki Ayaki, Minoru Fujita, Motoyuki Otsuka, Kaori Shigemitsu, Tomoki Yamatsuji, Ken Haruma
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.087
URL
https://academic.oup.com/dote/article-pdf/39/Supplement_1/doag077.087/70760874/doag077.087.pdf
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