Original Article

Ineffective Esophageal Motility with and Without Abnormal Acid Exposure: Clinical, Endoscopic, and Manometric Features

Volume 37 · Issue 10 Publish Date: July 27, 2026
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DOI
Harun Erdal ORCID
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Yusuf Coşkun ORCID
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Deniz Armağan Deniz ORCID
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Burak Birsoy ORCID
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Yusuf Üstün ORCID
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, 37(10), 1033–1041. 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. 2026;37(10):1033-1041.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 37 · Issue 10
Pages 1033-1041
History
Published Online July 27, 2026
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Affiliations
Harun Erdal ORCID
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Yusuf Coşkun ORCID
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Deniz Armağan Deniz ORCID
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Burak Birsoy ORCID
Department of Gastroenterology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Türkiye
Yusuf Üstün ORCID
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, 37(10), 1033–1041. https://doi.org/10.5152/tjg.2026.25627
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