Article 72

Background and Objectives: Dysphagia is a common problem in patients with primary motor disorders of the esophagus. Esophageal manom- etry is the gold standard for diagnosis of these disorders. Introduction of high resolution manometry represented a significant improvement in data recording and diagnostic yield. The objective of the study was to assess the findings of esophageal high resolution impedance manometry in patients presenting with dysphagia in Sulaimani governorate. Patients and Methods: This study extended from September, 2012 to December, 2013 and included 120 patients with dysphagia who were referred for manometry in Kurdistan Center for Gastroenterology and Hepatology (KCGH) in Sulaimani city. All patients underwent upper endoscopy to exclude mechanical and inflammatory causes of dysphagia then the high resolution impedance manometry was used with liquid and viscous swallows. Results: The mean age of the study population was 43 years. The female to male ratio was 1.5:1. The mean duration of dysphagia was 2 years. The most common esophageal motility abnormality was achalasia (N=44, 36.7%) followed by hypertensive LES (N=31, 25.8%), ineffective esophageal motility (N=9, 7.5%), hypotensive LES (N=5, 4.2%) and diffuse esophageal spasm (N=3, 2.5%). The high resolution impedance manometry was normal in 28 patients (23.3%). Of the 44 patients with achalasia, 15 patients (34%) had vigorous achalasia. Using Chica- go classification, the most common type of achalasia was type II (N=26, 59%) followed by type I (N=13, 29.6%) and then type III (N=5, 11.4%). Conclusions: Esophageal high resolution impedance manometry has an acceptable diagnostic yield in patients with dysphagia.The most common finding is achalasia. Further studies are recommended.