Approach to esophageal absent contractility: can we do better?

Amir Mari, Sari Cohen, Daniel L. Cohen, Tawfik Khoury, Fadi Abu Baker, Wisam Abboud, Edoardo Vincenzo Savarino, Marcella Pesce

Research output: Contribution to journalReview articlepeer-review


Absent contractility (AC), a motility disorder characterized by the absence of esophageal contractions while maintaining normal lower esophageal sphincter relaxation, is recognized as a distinctive major disorder of peristalsis on esophageal high-resolution manometry that warrants comprehensive understanding. This unique motility disorder often co-occurs with connective tissue, rheumatologic or autoimmune diseases, with scleroderma being the classic example. Symptoms of gastroesophageal reflux are common. AC can profoundly impact patients’ lives and result in a spectrum of complications, including erosive esophagitis, esophageal candidiasis, Barrett’s esophagus, and malnutrition. To address the intricate complexities of AC and its multifaceted complications, a multidisciplinary approach is paramount. This approach considers the distinct clinical presentation and underlying rheumatologic conditions of the individual patient, recognizing the inherent diversity within this disorder. While medical management of gastroesophageal reflux remains the cornerstone of AC treatment, emerging surgical and endoscopic interventions offer additional therapeutic options for those grappling with this challenging condition. This comprehensive review provides an in-depth evaluation of recent advances in our understanding of AC and its management. It endeavors to offer valuable insights into therapeutic strategies for AC and its associated issues.

Original languageEnglish
Pages (from-to)117-124
Number of pages8
JournalAnnals of Gastroenterology
Issue number2
StatePublished - 20 Mar 2024

Bibliographical note

Publisher Copyright:
© 2024 Hellenic Society of Gastroenterology.


  • Absent contractility
  • diagnosis
  • esophageal motility disorders
  • gastroesophageal reflux disease
  • management


Dive into the research topics of 'Approach to esophageal absent contractility: can we do better?'. Together they form a unique fingerprint.

Cite this