Esophageal dysbiosis and esophageal motility disorders

The esophageal microbiome is an emerging field of investigation. Better understanding of the relationships between the esophageal microbiome and esophageal motility disorders may impact clinical management and facilitate further understanding of esophageal pathophysiology and symptoms. In particular, study of the microbiome in profound esophageal motility disorders associated with esophageal stasis and impaired clearance, including achalasia spectrum disorders, Chagas disease, or other motility disorders with esophageal outflow obstruction, may afford insights into clinical diagnosis, risk stratification, treatment, and surveillance. The increased risks and potentially worse outcomes of esophageal neoplasia in these profound motor disorders warrant attention, given the likely role of esophageal dysbiosis in carcinogenesis. Finally, differences in the esophageal microbiome between achalasia spectrum disorders with esophageal outflow obstruction, and profound hypomotility disorders without outflow obstruction, may help improve our understanding of factors that contribute to inflammation and symptom generation.