We investigated the relationship between dysphagia during meals and esophageal motility in 53 patients (23 men and 30 women, average age 52.8±17.5 years, mean±SD, 19-92 years) without endoscopic abnormal findings aside from atrophic gastritis. Esophageal manometry was performed using the intraluminal microtransducer method. Resting lower esophageal sphincter (LES) pressure was assessed by the rapid pull-through method. Esophageal contraction after 10 repeated 5-ml water swallowings separated by 30 seconds was measured at 3, 8, 13, and 18cm above LES. In 53 patients with dysphagia, 40 (75.5%) showed esophageal dysmotility. Twenty-three patients with esophageal dysmotility had a typical motility disorder (classic achalasia, 5 patients ; vigorous achalasia, 3 patients ; diffuse esophageal spasm, 10 patients ; nutcracker esophagus, 4 patients ; hypertensive esophagus, 1 patient). Seventeen patients with esophageal dysmotility had non-specific esophageal motility disorder (NEMD). An increase in the severity of dysphagia was paralleled by a significantly increased prevalence of esophageal dysmotility. The remain-ing 13 patients did not have abnormal findings on esophageal manometry. Mean amplitudes 3 cm above LES in patients with NEMD were significantly lower than those of controls. The frequency of primary peristalsis in patients with NEMD was significantly lower than that of controls. The present results suggest that esophageal dysmotility contributes to dysphagia during meals in patients with dysphagia without endoscopic abnormal findings aside from atrophic gastritis.
