Chest pain and dysphagia in patients with prolonged peristaltic contractile duration of the esophagus

Herrington, J. Patrick; Burns, Theodore W.; Balart, Luis A.

doi:10.1007/bf01317054

Cited by 71 publications

(20 citation statements)

References 9 publications

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“…2). In agreement with other series [14,[18][19][20][21], the nutcracker esophagus (48%) was the most common motility disorder in these patients while classic DES (10%) was an infrequent finding. It should be remembered that the documentation of an esophageal motility disorder does not prove that it is the source of the patient's chest pain.…”

Section: Esophageal Manometrysupporting

confidence: 92%

Chest Pain of Esophageal Origin

Richter¹,

Castell²

1989

Dig Dis

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Section: Esophageal Manometrysupporting

confidence: 92%

Chest Pain of Esophageal Origin

Richter¹,

Castell²

1989

Dig Dis

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“…Several studies suggest that patients with chest pain or dysphagia have a high probability of esophageal dysfunction [24,25,26]. The symptom pattern of NE was similar to that of NSMD.…”

Section: Discussionmentioning

confidence: 85%

Insights Gained from Symptom Evaluation of Esophageal Motility Disorders: A Review of 4,215 Patients

et al. 2012

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Background/Aims: Achalasia (Ach), diffuse esophageal spasm (DES), nutcracker esophagus (NE), and nonspecific motility disorder (NSMD) are described primary esophageal body motility disorders; however, their clinical symptom correlation is poorly understood. The aim of this study is to examine the association between a patient’s presenting symptoms and their manometric diagnosis. Methods: Manometric findings and reported symptoms of all patients undergoing esophageal manometry at the Creighton University Medical Center were prospectively entered in a database. Twenty-four-year data from 1984 through 2008 were accessed and analyzed. Results: Of the 4,215 patients, 130 (3.1%) had Ach, 192 (4.6%) had DES, 290 (6.9%) had NE, 508 (12.1%) had NSMD, and 3,095 (73.4%) had normal esophageal body motility. There was significant symptom overlap between the groups. Ach and DES had a similar symptom distribution, with dysphagia being the predominant symptom. Patients with NE, normal body motility, and NSMD presented predominantly with reflux symptoms. There was an increasing prevalence of esophageal dysmotility (DES and NSMD) with age, and women were found to be more likely to have NE than men. Conclusion: In an individual, reported symptoms do not correlate with their manometric diagnosis in a predictable fashion, and a thorough physiological assessment should be obtained to understand and diagnose the disease process. Esophageal motility deteriorates with age.

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“…A nonspecific esophageal motor disorder (NEMD) has been postulated as a possible cause of both dysphagia and chest pain, with esophageal contractions of increased amplitude and duration [42]. Esophageal disorders are diagnosed in at least 30%-50% of patients with thoracic pain so that the endoscopic, radiographic, and manometric examination of the esophagus should be performed as well as the basic cardiologic techniques (e.g., EKG and stress tests) [43,44].…”

Section: Angina-like Chest Painmentioning

confidence: 99%

The gastroenterologist's approach to dysphagia

et al. 1993

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In the gastroenterological diagnostic armamentarium, dysphagia is considered as an important symptom for diseases of the esophagus. Concerning the history of illness, symptoms such as retrosternal pain and heartburn are often associated with gastroesophageal reflux disease. Morphological changes of the mucosa can be diagnosed by flexible endoscopy and radiographic examinations. Investigation with 24-h pH monitoring, manometry, and pharmacological tests is necessary for the diagnosis of functional disorders. Additionally, dysphagia can be associated with multiple internal diseases, including muscular diseases such as dermatomyositis, progressive systemic sclerosis, as well as lupus erythematosus. Difficulties in swallowing associated with hypo- and hyperthyroidism can also be interpreted as muscular lesions. Metabolic disorders such as alcoholism, and diabetes mellitus can be the cause of dysphagia. Increasing importance in the differential diagnosis of dysphagia is attached to infections of the upper GI tract. Especially in immunocompromised patients, infections of Candida albicans, mycobacterias, herpes, varicella zoster, and cytomegaloviruses can produce dysphagia and odynophagia. The differential diagnosis of the "angina-like chest pain" has to differentiate between cardiac disease and a noncardiac genesis. Therefore, besides the cardiac diagnostic investigation, endoscopy, radiography, and manometry are often indicated.

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Chest pain and dysphagia in patients with prolonged peristaltic contractile duration of the esophagus

Cited by 71 publications

References 9 publications

Chest Pain of Esophageal Origin

Chest Pain of Esophageal Origin

Insights Gained from Symptom Evaluation of Esophageal Motility Disorders: A Review of 4,215 Patients

The gastroenterologist's approach to dysphagia

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