FUNCTIONAL ABNORMALITIES OF THE ESOPHAGUS - A PROSPECTIVE ANALYSIS OFRADIOGRAPHIC FINDINGS RELATIVE TO AGE AND SYMPTOMS

OBJECTIVE. The prevalence and severity of functional abnormalities of the esophagus seen on fluoroscopic examination were compared with the age and-symptoms of the patients. SUBJECTS AND METHODS. The esophagus was examined radiographically in 139 consecutive outpatients 19-84 yea rs old. All patients completed a data sheet about their symptoms, and medical records were reviewed to determine the main indication for the examination. Videofluoroscopy was used to evaluate primary peristalsi s, proximal escape, and tertiary activity in the esophagus. The severi ty of proximal escape and activity was classified. RESULTS. Patients w ere categorized into three age groups: 39 years old or younger (n = 33 ); from 40 to 60: years old (n = 55); and 61 years old or older (n = 5 1). Abnormal esophageal motility, defined as disruption of peristalsis on two or more of five swallows, was found in 24% of patients 39 year s old or younger, 36% of patients from 40 to 60 years did, and in 49% of patients 61 years old or older (p > .05). However, evaluation of th e number of disrupted peristaltic swallows by age revealed 18% abnorma l swallows in patients 39 years old or older, 27% in patients from 40 to 60 years old, and 37% in patients 61 years old or older (p < .01). Proximal escape and tertiary contractions increased significantly with the age of the patient. Regardless of age, proximal escape was seen i n 79% of swallows and tertiary contractions were seen in 48% of swallo ws with disrupted peristalsis. The prevalence and severity of proximal escape and tertiary contractions increased in the older patients. Sym ptoms had no correlation with status of esophageal motility (p > .05). In 22 patients with secondary diseases, including rheumatoid arthriti s and diabetes mellitus, those diseases showed no correlation with the status of esophageal motility. CONCLUSION. The prevalence of function al abnormalities of the esophagus increased with age. Most patients wi th abnormal swallows showed proximal escape with or without tertiary a ctivity. Patients' symptoms and other diseases did not correlate with the status of their esophageal motility.