مانومتری مری در بیماران دچار دیسفاژی عملکردی: مقایسه بیماران پیر و جوان

  Background : Aging is a universal process that results in physiologic decline of organ systems. The effect of aging on esophageal motor function and the level of functional decline that could be responsible for symptoms are controversial. Dysphagia is a common symptom and is frequently blamed on "presbyesophagus" or considered the result of a stroke and therefore is not evaluated. Aim: The aim of this study was to determine if esophageal manometric findings and most common motility disorder in older patients with dysphagia differ significantly from younger patients. Materials & Methods: Consecutively performed manometry studies (n=218) were reviewed and among patients with dysphagia (n=102) two groups were chosen for the study those ≥ 65 years (n=22) and those ≤ 40 years (n=81). Presenting symptoms, manometric findings, and diagnosis were compared between two groups. Results: There were 59% women in the older group and 51.8% women in the younger group. The mean age of older group was 70 years ( ± 5.4) and the mean age in the younger group was 27.3 years ( ± 7.5). No significant difference was found between two groups in the symptoms of heartburn and chest pain. Lower esophageal sphincter (LES) resting pressure (20.8 vs 31.1, p<0.003) and residual pressure (6.2 vs 11.2, p<0.03) were lower in older patients than younger patients. LES percent of relaxation was higher in the older group (76.3 vs 63.4, p<0.02). There was no significant difference between two groups in regard to percent of aperistalsis. Older patients were as likely to have a normal study as younger patients. Frequency of non specific esophageal motility disorder (NEMD) in older patients was significantly more than younger patients (45% vs 7% p<0.001) and frequency of achalasia was less than younger patients (36% vs 68% p<0.008). Conclusion: Failure of esophagus does not appear to be an inevitable consequence of aging. When older patients present with dysphasia, esophageal manometry frequently yields a specific diagnosis to help explain their symptoms.