title: Clinical and manometric course of nonspecific esophageal motility disorders.
abstract: OBJECTIVE
  The evolution of nonspecific esophageal motility disorders remains unclear. The aim of this study was to investigate whether nonspecific esophageal motility disorders progress into specific motility disorders and whether such progression is predictable.
  
  
  METHODS
  Seventy-six symptomatic patients (49 males, 27 females, mean age 57 ± 16 years) with newly diagnosed nonspecific esophageal motility disorders were prospectively registered and followed-up. Follow-up visits, with structured interviews and manometric re-evaluation, were recommended biannually and whenever symptoms exacerbated.
  
  
  RESULTS
  Forty-three patients were followed for up to 4 years, symptoms worsened in 30% of patients, resolved in 26%, improved in 14% and were unchanged in 30%. Twenty-eight patients agreed to undergo manometric re-evaluation. Fifteen (53.6%) of these patients showed a progression to achalasia. The remaining patients continued to display features of nonspecific esophageal motility disorders (32%) or had normal motility (11%). The only significant association could be determined between age and progression to achalasia reaching nearly 100% in patients' ≤46 years of age. In contrast, none of the patients' ≥68 years progressed.
  
  
  CONCLUSIONS
  More than half of the patients in our cohort with nonspecific esophageal motility disorders showed a transition into achalasia. Neither manometric nor clinical findings predicted the progression of nonspecific esophageal motility disorders. However, young patients were more likely to progress to achalasia.
authors: Department of Gastroenterology, Deutsche Klinik für Diagnostik, Aukammallee 33, 65191 Wiesbaden, Germany. mueller.gastro@dkd-wiesbaden.de
authors: Michaela
authors: M
authors: Müller
authors: Alexander J
authors: AJ
authors: Eckardt
authors: Björn
authors: B
authors: Göpel
authors: Volker F
authors: VF
authors: Eckardt
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D004931:Esophageal Achalasia / Q000175:diagnosis* / Q000503:physiopathology*; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D010528:Peristalsis / Q000502:physiology; D011237:Predictive Value of Tests; D011312:Pressure; D012189:Retrospective Studies; D012720:Severity of Illness Index