Clinical course of chest pain associated with esophageal motility disorders following peroral endoscopic myotomy.

BACKGROUND AND AIMS: Chest pain affects the quality of life of patients with esophageal motility disorders (EMD). However, the natural course of EMD-related chest pain following treatment remains unclear. We aimed to elucidate the clinical course of EMD-related chest pain following peroral endoscopic myotomy (POEM).

METHODS

Patients who underwent POEM for EMD between April 2016 and March 2022 were enrolled. Patients under 18 years, those without chest pain before POEM, and those without a 1-year follow-up were excluded. The frequency and intensity of chest pain were recorded annually according to the chest pain component of the Eckardt score and the numerical rating scale (NRS). Meaningful improvement was defined as a ≥ 1-point reduction in the chest pain component of the Eckardt score, and independently, as a ≥ 2-point reduction on the NRS. Clinical improvement in chest pain was defined as a meaningful improvement in either the chest pain frequency or intensity.

RESULTS

In total, 168 patients were included in this study. The scores for chest pain intensity and frequency were reduced to 32% and 42% of preoperative values at 5 years after POEM. At 1 and 5 years after POEM, meaningful improvements in frequency were observed in 77% and 60% of patients, and in intensity in 92% and 81%, respectively. Clinical improvement in chest pain rate was 96% at 1 year and 87% at 5 years after POEM.

CONCLUSIONS

POEM was effective in treating EMD-related chest pain, particularly in terms of intensity.