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Objectives and Study Ineffective oesophageal motility (IEM) is the commonest oesophageal motility disorder identified on high-resolution manometry (HRM) in children. The causal relationship between IEM and gastro-oesophageal reflux disease (GORD) remains unclear. The aim of this study was to correlate oesophageal body contractility with MII-pH parameters and endoscopic findings.Material and Methods HRM and MII-pH data from children presenting with heartburn and/or vomiting symptoms between 2021 and 2025 were collected, excluding patients with previous oesophageal surgery, use of medications affecting oesophageal motility, or neurological disorders. Demographic, clinical, and endoscopic data were also recorded. IEM diagnosis was according to the CCv4.0 criteria. Mean wet swallow (WS) DCI was calculated as the average of the first ten wet swallows. Post-multiple rapid swallow (MRS) DCI was measured after a sequence of five 2-ml water swallows, and solid swallow (SS) DCI was calculated as the average of the first ten solid swallows.Result We identified 17 patients with IEM (mean age 11.9 years; 59% female) and 41 controls (mean age 14.2 years; 56% female). Mean WS DCI and SS DCI were significantly higher in controls (1084 mmHg/cm/sec and 1356 mmHg/cm/sec respectively) than in IEM patients (249.3 mmHg/cm/sec and 424.3 mmHg/cm/sec respectively) (p<0.0001), whereas no significant difference found for post-MRS DCI between groups (p=0.143). No significant group differences were noted in AET (total and supine), number of reflux episodes, mean nocturnal baseline impedance (MNBI), bolus clearance time (BCT) or oesophagitis (macroscopic or microscopic). Considering the whole children cohort (n=58), no significant correlations were observed between DCI versus AET, MNBI and BCT.Conclusion Oesophageal body contractility and MII-pH parameters are not directly correlated, suggesting that IEM is not a significant determinant of GORD pathophysiology.Abstract LBA7 Figure 1Correlation between wet swallow (WS) DCI and acid exposure time (AET) assessed by Spearman’s rank analysis (n=58)