title: Relationship between esophageal clinical symptoms and manometry findings in patients with esophageal motility disorders: a cross-sectional study.
abstract: BACKGROUND
  Manometry is the gold-standard diagnostic test for motility disorders in the esophagus. The development of high-resolution manometry catheters and software displays of manometry recordings in color-coded pressure plots have changed the diagnostic assessment of esophageal disease. The diagnostic value of particular esophageal clinical symptoms among patients suspected of esophageal motor disorders (EMDs) is still unknown. The aim of this study was to explore the sensitivity, specificity, and predictive accuracy of presenting esophageal symptoms between abnormal and normal esophageal manometry findings.
  
  
  METHODS
  We conducted a cross-sectional study of 623 patients aged 11-80 years. Data were collected from clinical examinations as well as patient questionnaires. The sensitivity, specificity, and accuracy were calculated after high-resolution manometry plots were reviewed according to the most recent Chicago Criteria.
  
  
  RESULTS
  The clinical symptoms were not sensitive enough to discriminate between EMDs. Nevertheless, dysphagia, noncardiac chest pain, hoarseness, vomiting, and weight loss had high specificity and high accuracy to distinguish EMDs from normal findings. Regurgitation and heartburn did not have good accuracy for the diagnosis of EMDs.
  
  
  CONCLUSIONS
  Clinical symptoms are not reliable enough to discriminate between EMDs. Clinical symptoms can, however, discriminate between normal findings and EMDs, especially achalasia.
authors.affiliation: Assistant Professor, Internist , Gastroenterologist, Research Center for Gastroenterology and Liver Disease, Department of Internal Medicine and Gastroenterology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran. hfyaseri@yahoo.com.
authors.forename: Hashem
authors.initials: H
authors.lastname: FakhreYaseri
authors.affiliation: General physician, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. fyasseri@mihanmail.ir.
authors.forename: Ali Mohammad
authors.initials: AM
authors.lastname: FakhreYaseri
authors.affiliation: MSc in Clinical Microbiology, Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. ak.baradaran@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Baradaran Moghaddam
authors.affiliation: Professor, Internist, Department of Internal Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran. soltarab34@gmail.com.
authors.forename: Seyed Kamran
authors.initials: SK
authors.lastname: Soltani Arabshhi
keywords: Achalasia; Esophageal motility disorders; Gastroesophageal reflux