scholarly journals Primary esophageal motility disorders: Concise review for clinicians

2006 ◽  
Vol 53 (3) ◽  
pp. 9-17 ◽  
Author(s):  
A. Simic ◽  
Z. Raznatovic ◽  
O. Skrobic ◽  
P. Pesko
Keyword(s):  
Esophageal Motility ◽  
Wide Spectrum ◽  
The Other ◽  
Esophageal Motility Disorders ◽  
Diffuse Esophageal Spasm ◽  
Nutcracker Esophagus ◽  
Motility Disorders ◽  
Esophageal Spasm ◽  
Concise Review ◽  
Primary Esophageal Motility Disorders

Primary esophageal motility disorders comprise various abnormal manometric patterns which usually present with dysphagia or chest pain. Some, such as achalasia, are diseases with a well defined pathology, characteristic manometric features, and good response to treatments directed towards the palliation of symptoms. Other disorders, such as diffuse esophageal spasm and nutcracker esophagus, have no well defined pathology and could represent a range of motility abnormalities associated with subtle neuropathic changes, gastresophageal reflux and anxiety states. On the other hand, hypocontracting esophagus is generally caused by weak musculature commonly associated with gastresophageal reflux disease. Although manometric patterns have been defined for these disorders, the relation with symptoms is poorly defined and in some cases the response to medical or surgical therapy unpredictable. The aim of this paper is to present a wide spectrum of the primary esophageal motility disorders, as well as to give a concise review for the clinicians encountering these specific diseases. .

scholarly journals Esophageal Motility Disorders: Current Concepts of Pathogenesis and Treatment

2000 ◽  
Vol 14 (3) ◽  
pp. 221-231 ◽  
Author(s):  
Peter J Kahrilas
Keyword(s):  
Rare Disease ◽  
Esophageal Motility ◽  
Laparoscopic Approach ◽  
Esophageal Motility Disorders ◽  
Primary Data ◽  
Pneumatic Dilation ◽  
Diffuse Esophageal Spasm ◽  
Nutcracker Esophagus ◽  
Functional Disturbance ◽  
Motility Disorders

Current concepts of esophageal motility disorders are summarized. Primary data sources were located via MEDLINE or cross-citation. No attempt was made to be comprehensive or inclusive of the literature because fewer than 10% of citations are discussed. Instead, emphasis was placed on new developments in diagnosis, therapeutics, and practice patterns. Controlled therapeutic trials and pathophysiological observations are emphasized. Achalasia is a rare disease of failed lower sphincter relaxation and aperistalsis. Diffuse esophageal spasm (DES), an equally rare disease, is defined by non-propagated esophageal contractions. Nonspecific motility disorders, including nutcracker esophagus and hypertensive lower esophageal sphincter, are identified only by manometry and are ten times as prevalent. Neuromuscular pathology is evident only with achalasia (myenteric plexus neurons destruction). Pharmacological therapies have limited efficacy with achalasia; more limited with DES; and none with the nonspecific motility disorders. More efficacious therapies for the nonspecific disorders are directed at associated reflux disease or psychiatric disorders. Pneumatic dilation is effective therapy for achalasia 72% of instances, but frequently requires repeat dilation and is complicated by a 3% perforation rate. Surgical myotomy is effective in 88% of achalasics; morbidity from thoracotomy has been the major limitation but this has been sharply reduced with a laparoscopic approach. In conclusion, although it has been suggested that esophageal motility disorders are distinct clinical entities, critical review of the literature supports this only in the case of achalasia, a disease of well defined pathophysiology, functional disturbance, and therapies. This clarity diminishes progressively for DES and non-specific esophageal motility disorders.

Dysphagia

2019 ◽  
Author(s):  
R. Sudhir Sundaresan ◽  
Anna L. McGuire
Keyword(s):  
Eosinophilic Esophagitis ◽  
Diagnostic Tests ◽  
Esophageal Motility ◽  
Esophageal Motility Disorders ◽  
Caustic Ingestion ◽  
Diffuse Esophageal Spasm ◽  
Epiphrenic Diverticulum ◽  
Motility Disorders ◽  
Esophageal Spasm ◽  
Schatzki Ring

Dysphagia may be oropharyngeal or esophageal. Evaluation is described, including a thorough dysphagia history of associated painful swallowing, location, solids versus liquids, intermittent versus progressive, acute versus gradual onset, and associated symptoms such as weight loss. Physical examination and key diagnostic tests are also reviewed. The evidence-based management of various etiologies of esophageal dysphagia are summarized. Motor disorders described include achalasia, the other primary esophageal motility disorders, and the most common secondary esophageal motility disorders. Esophageal diverticulae are also reviewed in this section. Mechanical esophageal obstruction is presented, including discussions of esophageal webs, rings, peptic stricture, and cancer. Important inflammatory and infectious causes of dysphagia are described, including caustic ingestion, eosinophilic esophagitis, and esophageal infections. The oral phases of liquid and solid swallowing are presented, as are the pharyngeal and esophageal phases of swallowing. Figures show the results of several diagnostic tests and other conditions, including pharyngeoesophageal diverticulum, giant epiphrenic diverticulum, Schatzki ring, and midesophageal squamous cell carcinoma. A flowchart outlines evaluation and management of dysphagia.  This review contains 13 figures, 12 tables, and 68 references.  Keyword: Esophageal cancer, Achalasia, Diffuse esophageal spasm, Esophageal ring, Peptic esophagitis, Eosinophilic esophagitis, Scleroderma, Esophageal stricture, Chagas disease, Stroke

Dysphagia

2019 ◽  
Author(s):  
R. Sudhir Sundaresan ◽  
Anna L. McGuire
Keyword(s):  
Eosinophilic Esophagitis ◽  
Diagnostic Tests ◽  
Esophageal Motility ◽  
Esophageal Motility Disorders ◽  
Caustic Ingestion ◽  
Diffuse Esophageal Spasm ◽  
Epiphrenic Diverticulum ◽  
Motility Disorders ◽  
Esophageal Spasm ◽  
Schatzki Ring

Dysphagia may be oropharyngeal or esophageal. Evaluation is described, including a thorough dysphagia history of associated painful swallowing, location, solids versus liquids, intermittent versus progressive, acute versus gradual onset, and associated symptoms such as weight loss. Physical examination and key diagnostic tests are also reviewed. The evidence-based management of various etiologies of esophageal dysphagia are summarized. Motor disorders described include achalasia, the other primary esophageal motility disorders, and the most common secondary esophageal motility disorders. Esophageal diverticulae are also reviewed in this section. Mechanical esophageal obstruction is presented, including discussions of esophageal webs, rings, peptic stricture, and cancer. Important inflammatory and infectious causes of dysphagia are described, including caustic ingestion, eosinophilic esophagitis, and esophageal infections. The oral phases of liquid and solid swallowing are presented, as are the pharyngeal and esophageal phases of swallowing. Figures show the results of several diagnostic tests and other conditions, including pharyngeoesophageal diverticulum, giant epiphrenic diverticulum, Schatzki ring, and midesophageal squamous cell carcinoma. A flowchart outlines evaluation and management of dysphagia.  This review contains 13 figures, 12 tables, and 68 references.  Keyword: Esophageal cancer, Achalasia, Diffuse esophageal spasm, Esophageal ring, Peptic esophagitis, Eosinophilic esophagitis, Scleroderma, Esophageal stricture, Chagas disease, Stroke

Botulinum Toxin Reduces Dysphagia in Patients With Nonachalasia Primary Esophageal Motility Disorders

2013 ◽  
Vol 11 (9) ◽  
pp. 1115-1121.e2 ◽  
Author(s):  
Tim Vanuytsel ◽  
Raf Bisschops ◽  
Ricard Farré ◽  
Ans Pauwels ◽  
Lieselot Holvoet ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Esophageal Motility ◽  
Esophageal Motility Disorders ◽  
Motility Disorders ◽  
Primary Esophageal Motility Disorders
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