Chest pain of esophageal origin. Where are we, and where should we go?

The esophagus is thought to be the cause of a large proportion of noncardiac chest pain syndromes. Often this is established solely by exclusion of more serious cardiopulmonary and esophageal-structural diseases. Using currently available manometric technology, a standardized esophageal manometric study and carefully defined values for normal, esophageal motility disorders (EMD) can be clearly defined. The subsequent development of an appropriate and generally agreed on nosology of EMD should serve as a basis for the prospective evaluation of these disorders, hopefully leading to a clear understanding of their exact importance and natural history. If the scientific method is used, order can be brought to this confusing area of clinical medicine.