The irritable oesophagus--a frequent cause of angina-like pain.

33 patients with angina-like chest pain of oesophageal origin were investigated. In 8 (24%) the pain proved to be related to oesophageal motor disorders unaccompanied by gastro-oesophageal reflux; in 12 (36%) acid reflux contributed to chest pain; but in the remaining 13 (40%) identical chest pain episodes were due to various mechanisms including reflux without motor disorders, motor disorders without reflux, motor disorders without reflux but with positive acid-perfusion test, and acid reflux without motility disorders but with positive edrophonium-stimulation test. These data strongly suggest that the mechanism of pain in these patients is related to irritability of the oesophagus.