Frequency of Esophageal Motility Disorders in Patients with Non-Cardiac Chest Pain

Background and purpose: Non-cardiac chest pain (NCCP) is a common entity with negative effects on quality of life that places a large financial burden on health systems. This study aimed at investigating esophageal motility disorders in patients with NCCP. Materials and methods: This cross-sectional study was conducted in 101 patients with recurrent chest pain without any cardiac disease, attending Ahvaz Imam Khomeini Hospital in a one-year period. Those who had no evidence of gastroesophageal reflux disease (GERD) on upper endoscopy and 24-hr esophageal pH monitoring were referred for conventional esophageal manometry. Results: From 101 patients, 51 showed endoscopic or pH-metric evidences of GERD. Manometric evaluation was done in 50 patients, including 27 males and 23 females (mean age: 44.2 years, 26-68 years old). Half of the cases (n=25) had abnormal motility disorders, including nonspecific esophageal motility disorder (20%), nutcracker esophagus (10%), diffuse esophageal spasm (8%), hypertensive LES syndrome (8%), and ineffective esophageal motility (4%). Esophageal motility disorders were found to have no significant associations with weight and age (P=0.125 and P=0.285).  The rate of esophageal motility disorders were lower in non-smokers (P=0.019). Conclusion: Esophageal motility disorders and GERD are frequent in patients with NCCP. Further studies are needed to establish a cause-effect relationship.