BACKGROUND: Nonspecific esophageal motility disorder (NEMD) has become a catchall term to describe abnormal esophageal manometric findings that do not meet strict criteria for established esophageal motility disorders. The aim of this study was to determine whether NEMD is a real esophageal motility disorder characterized by impairment of its motor function or simply a manometric disturbance with no clinical consequences. METHODS: Esophageal transit of liquid and semisolids was studied using radioscintigraphic techniques in 10 symptomatic patients with manometrically diagnosed NEMD, 26 healthy control subjects, and 40 disease control subjects. The disease controls included 24 patients with achalasia, 9 with scleroderma, and 7 with diffuse esophageal spasm. RESULTS: Patients with NEMD had no impairment of liquid emptying compared with healthy controls. Liquid emptying was markedly delayed in patients with achalasia and scleroderma. However, semisolid emptying was markedly delayed in patients with NEMD compared with healthy controls (P < 0.001), and the extent of its delayed emptying was similar to that seen in patients with achalasia, scleroderma, and diffuse esophageal spasm. CONCLUSIONS: NEMD is not a manometric curiosity but a disorder characterized by selective impairment of semisolid emptying.
BACKGROUND: Nonspecific esophageal motility disorder (NEMD) has become a catchall term to describe abnormal esophageal manometric findings that do not meet strict criteria for established esophageal motility disorders. The aim of this study was to determine whether NEMD is a real esophageal motility disorder characterized by impairment of its motor function or simply a manometric disturbance with no clinical consequences. METHODS: Esophageal transit of liquid and semisolids was studied using radioscintigraphic techniques in 10 symptomatic patients with manometrically diagnosed NEMD, 26 healthy control subjects, and 40 disease control subjects. The disease controls included 24 patients with achalasia, 9 with scleroderma, and 7 with diffuse esophageal spasm. RESULTS:Patients with NEMD had no impairment of liquid emptying compared with healthy controls. Liquid emptying was markedly delayed in patients with achalasia and scleroderma. However, semisolid emptying was markedly delayed in patients with NEMD compared with healthy controls (P < 0.001), and the extent of its delayed emptying was similar to that seen in patients with achalasia, scleroderma, and diffuse esophageal spasm. CONCLUSIONS: NEMD is not a manometric curiosity but a disorder characterized by selective impairment of semisolid emptying.