Esophageal rings and strictures. Manometric characteristics in patients with food impaction.

PURPOSE: The purpose was to investigate the manometric characteristics in patients with lower esophageal rings or strictures with special reference to food impaction.

MATERIAL AND METHODS: The material comprised 344 patients (158 female and 186 male). Lower esophageal rings or strictures were diagnosed radiologically by the full column technique. Manometry was performed with triple lumen catheters connected to a hydraulic capillary system and external transducers.

RESULTS: Forty patients had rings, and 21 patients strictures. The reference group comprised 283 patients. Dysphagia was seen most frequently in patients with rings. Food impaction was seen only in patients with rings or strictures, whereas chest pain and heartburn appeared with the same incidence in all 3 groups. Non-specific motor disorders were seen most frequently in patients with strictures, but as delayed esophageal emptying with no influence on the tendency to food impaction. Only ring diameter, but not stricture diameter, was of any significance with a higher incidence of food impaction in patients with narrow rings.

CONCLUSION: Radiology rather than manometry should be the first diagnostic step in patients with benign dysphagia suffering from food impaction.