Dysphagia

, Volume 5, Issue 4, pp 211–215 | Cite as

Esophageal motility, heartburn, and gastroesophageal reflux: Variations in clinical presentation of esophageal dysphagia

  • Dennis L. Decktor
  • Melvin L. Allen
  • Malcolm Robinson
Article

Abstract

Dysphagia is a potentially important symptom, often leading to the finding of an anatomical or motility disorder of the esophagus. Dysphagia and heartburn represent two of the most common symptoms associated with esophageal motility disorders. To explore the relationship of symptomatic esophageal dysphagia and heartburn and their association with primary esophageal motor disorders, we have performed a retrospective assessment of 1035 patient evaluations performed at our gastrointestinal laboratory. A clear statistical association of symptomatic dysphagia and heartburn was established; however, no pattern diagnostic of a specific motility disorder was discernible. A sizable fraction of our patient population with dysphagia demonstrated normal esophageal motility. A significant portion of dyspeptic patients exhibited both normal motility and acid exposure. The differences observed between the incidence of subjective symptoms and objective dysfunction may be explained in part by an altered or increased esophageal sensitivity of these patients.

Key words

Dysphagia Deglutition Deglutition disorders Gastroesophageal reflux Dysphagia, symptoms Heartburn 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Benjamin SB., Richter JE, Cordova CM, Knuff TE, Castell DO: Prospective manometric evaluation with pharmacological provocation of patients with suspected oesophageal motility dysfunction.Gastroenterology 84:893–901, 1983PubMedGoogle Scholar
  2. 2.
    Edwards DAW: Flow charts, diagnostic keys and algorithms in the diagnosis of dysphagia.Scott Med J 15:378, 1970PubMedGoogle Scholar
  3. 3.
    Russell COH, Hill LD, Holmes ER III, Hull DA, Gannon R, Pope CD II: Radionuclide transit: a sensitive screening test for esophageal dysfunction.Gastroenterology 80 (5 pt 1):887–892, 1981PubMedGoogle Scholar
  4. 4.
    Nelson JB, Castell DO: Esophageal motility disorders.DM 34 (6), 1988Google Scholar
  5. 5.
    Jones C:Digestive Tract Pain. New York: Macmillan, 1938Google Scholar
  6. 6.
    Kramer P, Hollander W: Comparison of experimental esophageal pain with clinical pain of angina pectoris and esophageal disease.Gastroenterology 29 (5):719–743, 1955PubMedGoogle Scholar
  7. 7.
    Bernstein LM, Baker TA: A clinical test for esophagitis.Gastroenterology 34:760–781, 1958PubMedGoogle Scholar
  8. 8.
    Richter JE, Barish CF, Castell DO: Abnormal sensory perception in patients with esophageal chest pain.Gastroenterology 91:845–852, 1986PubMedGoogle Scholar
  9. 9.
    Deschner WK, Maher KA, Cattau EL Jr, Benjamin SB: Manometric responses to balloon distention in patients with nonobstructive dysphagia.Gastroenterology 97:1181–1185, 1989PubMedGoogle Scholar
  10. 10.
    Ritchie J: Pain from distention of the pelvic colon by inflating a balloon in the irritable colon syndrome.Gut 14:125–132, 1973PubMedGoogle Scholar
  11. 11.
    Whitehead WE, Engel BT, Schuster MM: Irritable bowel syndrome. Physiological and psychological differences between diarrhea-predominant and constipation-predominant patients.Dig Dis Sci 25:404–413, 1982CrossRefGoogle Scholar
  12. 12.
    Kullmann G, Fielding JF: Rectal distensibility in the irritable bowel syndrome.Ir Med J 74:140–142, 1981PubMedGoogle Scholar
  13. 13.
    Siegel CI, Hendrix TR: Esophageal motor abnormalities induced by acid perfusion in patients with heartburn.J Clin Invest 42:(5) 686–695, 1963PubMedCrossRefGoogle Scholar
  14. 14.
    Kahrilas PJ, Dodds WJ, Hogan WJ, Kern M, Arndorfer RC, Reece A: Esophageal peristaltic dysfunction in peptic esophagitis.Gastroenterology 91:897–904, 1986PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1990

Authors and Affiliations

  • Dennis L. Decktor
    • 1
  • Melvin L. Allen
    • 1
  • Malcolm Robinson
    • 1
  1. 1.Oklahoma Foundation for Digestive ResearchOklahoma CityUSA

Personalised recommendations