Ineffective esophageal motility (IEM) is an esophageal motility and is the most common abnormality seen routinely in esophageal manometry. Here we assessed the clinical features of patients with IEM and the effects of proton pump inhibitors (PPI) and surgical treatments on patient’s conditions.

This is a cross-sectional study that was performed in 2019-2020 in Isfahan on 40 cases with the diagnosis of IEM. We collected demographic information of patients (age, sex, BMI, previous medical history, medications, duration of the current problem) and clinical manifestations (clinical symptoms of patients including dysphagia, heartburn, acid reflux, chest pain or belching) before and after treatments with PPI or surgery.

65% of patients had dysphagia and heartburn, 55% had food and acid regurgitation , 47.5% had belching and 55% had chest pain. Post-treatment findings showed that only the recurrence of food and acid regurgitation in the PPI treatment group was significantly lower than the surgical group. Intragroup comparison of symptom severity showed that in the surgical group only the severity of dysphagia (P=0.042) and in the PPI group the severity of heartburn (P=0.007), dysphagia (P<0.001), food and acid regurgitation (P=0.007) and chest pain (P=0.027) decreased significantly compared to before treatments.

Dysphagia and heartburn, food or acid reflux and burping were the most common clinical manifestations of IEM. Treatments with PPI resulted in more significant improvements compared to surgical treatments.