Relative Prevalence of Esophageal Motility Disorders in Patients with Esophageal Symptoms and Relationship between Motility Disorders and Symptoms

Song, Hyun Ju; Lee, Kwang Jae; Lee, Eun Hee; Kim, Do Hyun; Park, So Yune; Hahm, Ki Baik; Kim, Jin Hong; Cho, Sung Won

Abstract

BACKGROUND/AIMS
Motility disorders of the esophagus can cause a variety of esophageal complaints. However, the relevance of motility abnormalities to patients' symptoms has not been established yet. In this study, we aimed to determine the relationship between esophageal motility disorders and esophageal symptoms.
METHODS
238 patients, who were referred for evaluation of esophageal symptoms and diagnosed as one of primary esophageal motility disorders through standard esophageal manometry between June 2001 and October 2003, were enrolled. Esophageal symptoms and the findings of esophageal manometry and a 24-hr ambulatory esophageal pH study were analysed.
RESULTS
Among the 238 patients, globus and non-specific chest pains were most common. Ineffective esophageal motility (IEM) was most frequently observed, followed by nutcracker esophagus and hypertensive LES. IEM was most common motility abnormality in patients with globus sensation, dysphagia, heartburn, regurgitation and odynophagia. In patients with IEM and nutcracker esophagus, globus sensation was the most frequent complaint. Patients with hypertensive LES and diffuse esophageal spasms most frequently complained of non-specific chest pain. In patients with achalasia and incomplete LES relaxation, dysphagia was most commonly occurred. There were no differences in symptom profiles between IEM (esophageal hypomotility) and nutcracker esophagus (esophageal hypermotility), except that dysphagia was more common in patients with IEM than those with nutcracker esophagus. Pathologic acid reflux was more frequently observed in patients with IEM than those with nutcracker esophagus.
CONCLUSIONS
Esophageal motility disorders may produce diverse symptoms, and symptom patterns are not specific for motility abnormalities. Thus, esophageal function tests are required for the effective management of esophageal symptoms.