Esophageal manometry in patients with clinical symptoms mimicking esophageal origin: a hospital-based ten-year experience.
BACKGROUND
Primary esophageal motility disorder, which can cause chest pain or dysphagia, is seldom reported in Chinese. With the introduction of an easy and less uncomfortable method to perform esophageal manometry by low-compliance perfusion system, we studied symptomatic patients for more than 10 years. These data were analyzed and were compared to Western reports.


METHODS
From August 1989 to June 1999, 264 patients with symptoms mimicking esophageal origin, such as chest pain, dysphagia or odynophagia, but without secondary motility disorders were enrolled. Esophageal manometry was performed on each patient.


RESULTS
Among 264 manometric tracings, 142 (54%) were normal and 122 (46%) were abnormal. In patients with abnormal tracings, 73 were nonspecific esophageal motility disorder (NEMD), 20 were achalasia, 9 were diffuse esophageal spasm (DES), 8 were nutcracker esophagus, 7 were hypotensive low esophageal sphincter (LES), 3 were abnormal provocative test by edrophonium, and 2 were hypertensive LES. As in Western countries, the most common abnormality was NEMD. However, our series did not find many patients with DES, nutcracker esophagus and hypertensive LES. Similar results were noted in patients with NEMD, that most had increased nontransmitted contractions and low contraction amplitude.


CONCLUSIONS
We found that primary esophageal motility disorder is not uncommon in Taiwan. Esophageal manometry should always be considered in patients with symptoms mimicking esophageal origin.
Lee
Chia-Long
CL
Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan, ROC. cghleecl@cgh.org.tw
Wu
Chi-Hwa
CH
Chen
Tzen-Kwan
TK
Tu
Tien-Chien
TC
D000328:Adult; D015154:Esophageal Motility Disorders / Q000175:diagnosis*; D004947:Esophagus / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged