Clinical Evaluation of Radionuclide Esophageal Transit Study in Patients with Nonspecific Esophageal Motility Disorder

Song, Chi Wook; Hyun, Jin Hai

Abstract

OBJECTIVES
Nonspecific esophageal motility disorder(NEMD) is a vague category used to group poorly defined contraction abnormalities. We evaluated the clinical characteristics and esophageal transit time (ETT) in patients with NEMD.
METHODS
Total 205 patients with NEMD were compared with 20healthy controls and 99patients with other motility disorders of the esophagus. Esophageal manometry was performed with a lowcompliance pneumohydraulic capillary infusion system and esophageal scintigraphy was performed for the liquid and solid swallow after manometric study.
RESULTS
1) Among the total 258abnormal contractions in 205patients with NEMD, non-transmitted contractions were 125(45.5%), low amplitude 110(42.6%), triple peaked 3(1.2%), prolonged duration contractions 12(4.7%) and isolated incomplete LES relaxation 8(3.1%). 2) NEMD patients have significantly delayed ETT similar to that seen in patients with diffuse esophageal spasm, nutcracker esophagus, hypertensive lower esophageal sphincter for liquid, and diffuse esophageal spasm, hypertensive lower esophageal sphincter for solid. 3) ETT for liquid and solid according to abnormal contractions were 39.0 and 55.6seconds in non-transmitted, 38.3, 68.4 seconds in low amplitude, 17.0, 30.0 seconds in triple peaked, 29.4, 25.8 seconds in prolonged-duration contractions and 13.7, 15.5 seconds in isolated incomplete LES relaxation, respectively.
CONCLUSION
Patients with NEMD have significantly delayed ETT for liquid and solid compare to normal control. The main abnormal contractions of NEMD were non-transmitted and low amplitude contractions. And low amplitude contractions were the main cause of delayed solid transit in patients with NEMD(p<0.01).