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News

Esophageal motor function in patients with dysphagia or chest pain

The most common esophageal motility abnormality in patients with non-cardiac chest pain is a hypotensive lower esophageal sphincter, find physicians in the December issue of Alimentary Pharmacology and Therapeutics.

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Data on the distribution of esophageal motor abnormalities in patients being evaluated for non-cardiac chest pain and/or dysphagia are scarce.

In this study, physicians from the Unites States evaluated the distribution of esophageal motor abnormalities in patients with dysphagia, non-cardiac chest pain or both.

The team examined data from the national Clinical Outcomes Research Initiative (CORI) database. The CORI esophageal motility database originates from 19 community, university and VA medical centers.

The CORI database included 587 consecutive patients who underwent motility studies between 1998 and 2001.

The physicians found that 69% of patients had dysphagia as their primary indicator for the examination, 24% had non-cardiac chest pain, and 7% had both dysphagia and non-cardiac chest pain.
Normal motility was the most frequent finding.
Alimentary Pharmacology and Therapeutics

In all of these patients groups, a normal motility study was the most frequent finding.

The team determined that the most common motility abnormality in the non-cardiac chest pain group was a hypotensive lower esophageal sphincter.

They found that nutcracker esophagus and non-specific esophageal motility disorders were each occurred in 10% of patients with non-cardiac chest pain.

In patients with dysphagia, ineffective peristalsis occurred in 27% of patients, achalasia in 18%, and non-specific esophageal motility disorders in 14%.

However, achalasia and non-specific esophageal motility disorders were the most common motility abnormalities in patients with both chest pain and dysphagia.

Dr Dekel's team concluded, "The most common esophageal motility abnormality in patients with non-cardiac chest pain is a hypotensive lower esophageal sphincter".

"Nutcracker esophagus and non-specific esophageal motility disorders are relatively uncommon".

"The most common esophageal motility abnormality in patients with dysphagia is ineffective peristalsis and, for those with both dysphagia and non-cardiac chest pain, it is achalasia".

Aliment Pharmacol Ther 2003; 18(11-12): 1083-9
08 December 2003

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