Clinical utility of oesophageal manometry in evaluation of chest pain and dysphagia at tertiary centre

Abstract

Background:Manometry is the gold standard test for diagnosis esophageal motility disorders. Disordered esophageal motor function is a common cause of symptom as particularly dysphagia, chest pain, and those associated with gastroesophageal reflux. Manometric studies are used in the evaluation of patients with symptoms suggestive of esophageal origin such as dysphagia, odynophagia, heartburn, and unexplained chest pain. Motor function can be assessed by a variety of recording techniques including radiology, scintigraphy manometer, and most recently intraluminal electrical impedance monitoring. Some of these are complementary. The gold standard, however, for the assessment of motor disorders remains manometry. Hypertensive LES, ineffective esophageal motility and nonspecific esophageal motility disorder are effectively diagnosed. Manometric measurement of esophageal pressure is the most direct method for assessment of motor function.

Methods: A prospective study done in department of surgery, Vijaya Nagara Institute of Medical Sciences, Bellary, Karnataka, India, between December 2010 to May 2012. Study included 30 patients of age 18-80 years were evaluated by oesophageal manometry who presented with non-cardiac chest pain and dysphagia.

Results:Manometric evaluation of patients presenting with non-cardiac chest pain and dysphagia revealed, hypotensive LES was most common constituting 39.6% of cases followed by, hypertensive LES (16.5%), achalasia (13.2%), ineffective esophageal motility (13.2%), nonspecific esophageal motility disorder (9.9%), nutcracker and diffuse esophageal spasm (3.3%).

Conclusions:Oesophageal manometry helps in identifying different motility disorder and delineates the treatment plan based on the recordings.