Standard Esophageal Manometric Finding in Dysmotility-like Functional Dyspepsia

Lee, Kwang Jae; Hwang, Il Ran; Kim, Jin Hong; Kim, Jung Min; Hahm, Ki Baek; Cho, Sung Won

Abstract

BACKGROUND/AIMS: Functional dyspepsia(FD) is primarily a symptom complex. There is no consensus on the pathogenesis of functional dyspepsia. Disorders of motor function of the upper gastrointestinal tract have been implicated in the pathogenesis of FD. About 25-60% of patients with FD have delayed gastric emptying and postprandial antral hypomotility. Intestinal dysmotility is common in patients with severe and incapacitating FD. But there were few reports about association with esophageal dysmotility in FD. We performed this study to investigate the esophageal motility in patients with dysmotility-like FD.
METHODS
The study included twenty-three patients (M:F=6;17, mean age: 42.5 years) referred to Ajou University Hospital for evaluation of their dyspepsia from July 1994 to July 1997. All patients underwent routine blood tests, upper gastrointestinal series or esophagogastroduodenoscopy and abdominal ultrasound to rule out organic cause of dyspepsia. The patients with reflux-like symptoms such as heartbum and/or regurgitation and noncardiac chest pain were also excluded. Standard esophageal manometry was done with pneumohydraulic capillary infusion system.
RESULTS
1) Out of 23 patients, 12 patients showed normal esophageal manometric finding, 11 patients(47.8%) abnormal finding. Esophageal manometry revealed hypertensive upper esophageal sphinter (UES) in 3 patients, hypertensive lower esophageal sphinter (LES) in 2 patients, hypotensive LES in 1 patients. Four patients showed nonspecific esophageal motility disorder low-amplitude contractions in 3 patients, nontransmitted contractions in 1 patient). One patient exhibited nutcracker esophagus. 2) Out of 23 patients, 5 patients also complained of symptoms consistent with lower gut dysfuctian, chiefly irritable bowel syndrome. Three of these patitnets revealed abnormal esophageal manometric finding (hypertensive UES in 2 patient, low-amplitude contractions in one patient).
CONCLUSIONS
This findings indicate that some patients with FD have esophageal manometric abnormalities. The esophageal motor dysfunction was mainly observed in esophageal body and lower esophageal sphinter, which are made up of smooth muscle.