Clinical Characteristics and Gastroesophageal Reflux in Patients with Diffuse and Segmental Nutcracker Esophagus

Kim, Gwang Ha; Lee, Dong Hyun; Jeong, Woo Jin; Park, Won Il; Park, Jin Hong; Kim, Jin Seon; Heo, Jeong; Kang, Dae Hwan; Song, Geun Am; Cho, Mong; Yang, Ung Suk

Abstract

BACKGROUND/AIMS
The most common esophageal motility abnormality in patients with noncardiac chest pain is nutcracker esophagus. Most investigators regard nutcracker esophagus as a diffuse process involving the distal esophagus. Others consider it a segmental disturbance affecting any level of the esophagus. This study compared the clinical characteristics and gastroesophageal reflux between two groups of nutcracker esophagus patients: diffuse and segmental.
METHODS
From July 2002 to October 2003, 50 patients were diagnosed as nutcracker esophagus and were grouped into diffuse type (24 patients) and segmental type (26 patients). Of them, 35 patients underwent 24-hour ambulatory pH monitoring and 42 underwent gastroscopy.
RESULTS
The groups did not differ significantly with respect to the clinical characteristics such as hypertension, ischemic heart disease, chest pain, dysphagia, heartburn, acid regurgitation, laryngitis, globus or hoarseness. They did not show any significant difference in gastroesophageal reflux parameters by 24-hour ambulatory pH monitoring and gastroscopic findings. Gastroesophageal reflux disease was diagnosed in 33.3% of diffuse types and in 38.5% of segmental types, which was not significantly different (p=0.706).
CONCLUSIONS
There was no significant difference in clinical characteristics or gastroesophageal reflux between the diffuse nutcracker esophagus group and the segmental nutcracker esophagus group.