Esophageal motility disorders in clinical practice.

Motor disorders of the esophagus are varied. Some of these disorders can be caused by an abnormality of the esophageal muscle and others are secondary to a systemic disease. In any case, dysphagia should always be regarded as an important symptom and carefully investigated. The first step is to obtain a detailed history. A specific esophageal lesion, such as stricture, ring, tumor, or esophagitis, should then be ruled out by roentgenography and endoscopy. If these two diagnostic procedures fail to show the cause of the dysphagia, esophageal manometry is helpful in identifying a specific motor abnormality. This procedure has also contributed greatly to the understanding of esophageal physiology.