Correlations between esophageal diseases and manometric length: A study of617 patients

The purpose of this study was to measure the length of the esophagus and as sess its relationship to sex, weight, age, height, and various esophageal d isorders. A retrospective analysis was undertaken of 617 esophageal manomet ric studies, which included 51 normal control subjects (27 males and 24 fem ales) and 566 patients (297 males and 269 females) with esophageal disorder s (50 with achalasia, 6 with diffuse esophageal spasm, 6 with strictures, 3 8 with nutcracker esophagus, 398 with gastroesophageal reflux disease [GERD ] with positive 24-hour pH monitoring, and 66 with possible GERD but negati ve 24-hour pH monitoring). Manometry was performed in all of them by the st ation pull-through technique. The length of the esophagus was defined as th e distance between the proximal end of the upper esophageal sphincter and t he distal end of the lower esophageal sphincter. In the control group the m ean (+/- standard deviation) length of the esophagus was 28.3 +/- 2.41 cm. In patients with esophageal disorders the mean length of the esophagus was 28.0 +/- 2.87 cm. Length of the esophagus is related to height but not to w eight, sex, age, diffuse esophageal spasm, or nutcracker esophagus. Achalas ia is associated with a longer esophagus, and GERD is associated with a sho rter esophagus. Stricture is associated with a shorter esophagus, but this is in part due to the association between stricture and GERD. Patients with possible GERD but negative 24-hour pH monitoring have an esophageal length similar to that of GERD patients with positive 24-hour pH monitoring. Pati ents with GERD and stricture formation showed esophageal shortening in shor ter patients. Achalasia, GERD, and GERD with stricture formation influence esophageal length. GERD-related strictures shorten the esophagus more signi ficantly in short patients.