Manometric and clinical characterization of non-obstructive esophageal dysphagia focusing on its impact on quality of life.

Non-obstructive esophageal dysphagia (NOD) is a benign condition frequently encountered in clinical practice, often associated with motility disorders, with consequences surpassing the physical dimension and extending to the patient's personal life. However, its characterization, particularly focusing on its impact on quality of life (QoL), remains limited. This prospective study aimed to characterize this population regarding epidemiological, clinical, and manometric aspects. From September 2021 to February 2024, 250 NOD patients were recruited from seven centers. All subjects underwent a comprehensive diagnostic work-up, including upper endoscopy with biopsies, high-resolution esophageal manometry, and timed barium esophagogram, when applicable. Epidemiological and clinical data were collected using the Eckardt, Gerd-Q, and the Portuguese versions of Euro-Qol-5D-3L (EQ-5D) and PROMIS Gastrointestinal Disrupted Swallowing (PDS) scales. Patients were predominantly female (60.8%) with a median age of 63 years [IQR 20]. According to Chicago v4.0, normal esophageal motility was the most frequent diagnosis (n = 93, 37.2%), followed by esophagogastric junction (EGJ) outflow disorders (79 achalasia, 4 EGJ outflow obstruction). Among motility disorders, Eckardt and PDS scores were higher in EGJ outflow disorders (median 5 and mean T-score 64.1, respectively; P < 0.001), although their ability to primarily identify these conditions was limited. Regarding patient-reported QoL, no significant differences were found in EQ-5D, both for time trade-off and visual analog scale values. In summary, normal esophageal motility was the most frequent manometric finding in NOD patients. Although symptom severity was worse in EGJ outflow disorders, QoL appeared equally affected across all motility profiles.