Role of stationary esophageal manometry in clinical practice. Manometric results in patients with gastroesophageal reflux, dysphagia or non-cardiac chest pain.
The present study was carried out to evaluate the diagnostic usefulness of stationary esophageal manometry in 263 patients divided into three groups: 150 patients with reflux symptoms, 68 with dysphagia, and 45 with non-cardiac chest pain. Patients with endoscopic abnormalities were excluded. Standard manometry was performed following the station pull-through technique. In the group of patients with reflux symptoms 40.7% had a normal manometry and 57.3% had abnormalities, being the most frequent (43%) hypotensive lower esophageal sphincter. In the dysphagia group, 20.6% of manometries were normal and 79.4% were abnormal, of which achalasia was the most frequent disorder (53.7%). In the case of non-cardiac chest pain, 42.2% of patients had a normal manometry and 57.8% an abnormal one, of which hypotensive lower esophageal sphincter was the most frequent abnormality. A significant higher proportion of manometric alterations were found in the dysphagia group compared to reflux symptoms and non-cardiac chest pain (p < 0.05). No statistical differences were found between the reflux and the non-cardiac chest pain groups. Manometry yields a higher diagnostic value in patients with dysphagia, and therefore manometry should be performed routinely after the exclusion of any organic esophageal disease. Manometry is not a first-choice functional diagnostic test in the study of patirnts with gastroesophageal reflux or non-cardiac chest pain.
Ciriza de los Ríos
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C
Laboratory of Clinical Motility, Service of Gastroenterology, Hospital del Bierzo, León, Spain. lgarcia@hbrz.sacyl.es
García Menéndez
L
L
Díez Hernández
A
A
Delgado Gómez
M
M
Fernández Eroles
A L
AL
Vega Fernández
A
A
San Sebastián
A I
AI
Romero Arauzo
M J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D003937:Diagnosis, Differential; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008365:Manometry / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D012680:Sensitivity and Specificity