Age and gender affect likely manometric diagnosis: Audit of a tertiary referral hospital clinical esophageal manometry service.
OBJECTIVE
Awareness of patient demographics, common diagnoses and associations between these may improve the use and interpretation of manometric investigations. The aim of the present study therefore was to determine whether age and/or gender affect manometric diagnosis in a clinical motility service.


METHODS
An audit of all 452 clinical manometry reports issued from December 2003 to July 2005 with respect to age, gender and diagnosis was carried out. Patients were divided by age (17-24 years n = 14, 25-44 years n = 87, 45-64 years n = 216 and >or=65 years n = 135), and gender and data compared using contingency tables.


RESULTS
Women were more commonly referred overall (59%) and in each age bracket except <25 years (64% male). Men were more likely to have 'hypotensive' motor problems P = 0.01. With aging, normal motor function became less common (P = 0.013), with non-specific motor disorder, ineffective/hypotensive peristalsis and 'achalasia-like' conditions each more common (individual P = NS). Increasing age showed a trend for increased spastic motor disorders (P = 0.06). Gender did not, however, influence whether motility was abnormal (P = 0.5), spastic (P = 0.7) or whether a non-specific motor disorder was present (P = 0.1). In the total cohort, the principal manometric diagnoses were: non-specific motor disorder 33%, normal motility 29%, low basal lower esophageal sphincter pressure 18%, hypotensive/ineffective peristalsis 10%, achalasia/achalasia-like 6%, diffuse esophageal spasm 3% and other 1%.


CONCLUSIONS
Aging leads to increasing esophageal motor abnormalities. Men and women have similar rates of dysfunction, although 'low-pressure problems' were more common in men.
Andrews
Jane M
JM
Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia. jane.andrews@health.sa.gov.au
Heddle
Richard
R
Hebbard
Geoffrey S
GS
Checklin
Helen
H
Besanko
Laura
L
Fraser
Robert J
RJ
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D054869:Clinical Audit; D004935:Esophageal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005762:Gastroenterology / Q000592:standards*; D005769:Gastrointestinal Motility; D006748:Hospital Departments / Q000592:standards*; D006801:Humans; D008297:Male; D008365:Manometry / Q000592:standards*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011237:Predictive Value of Tests; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000592:standards*; D015203:Reproducibility of Results; D017678:Sex Distribution; D012737:Sex Factors; D055815:Young Adult