''Nutcracker'' esophagus: Does this entity truly exist: Correlative study of radionuclide esophageal scintigraphy and manometry

''Nutcracker'' esophagus is a syndrome consisting of chest pain and elevation of the mean distal esophageal contractile amplitude (MDA) (>120 mm Hg). Both its existence as a disorder of esophageal function and the proper manometric diagnostic criteria have been debated. The authors performed a correlative study of radionuclide esophageal scintigraphy (RES) and manometry in 31 patients with this manometric diagnosis. Moderate correlation was found between MDA and percent emptying on RES (r = -.48, P <.001) or transit time on RES (r = .54, P <.01). RES confirmed a functional disorder in a subgroup of patients with the manometric diagnosis of ''nutcracker'' esophagus. The findings support a change in the manometric criteria for diagnosis of this disorder to an MDA above 150 mm Hg