China
Africa
Explore chapters and articles related to this topic
Esophageal Disorders and Their Relationship to Psychiatric Disease
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Laurence A. Bradley, Joel E. Richter
The first-line treatments for diffuse esophageal spasm and related motility disorders include: 1) antireflux therapy, 2) nitrate, anticholinergic, or calcium channel blocking agents, and 3) anxiolytic or antidepressant medications such as alprazolam, buspirone, amitriptyline, or trazodone (64). However, it may be necessary for physicians to perform trials of all these treatments in a serial fashion, as most of these therapies have not been shown to be superior to placebo in controlled studies (4).
Causes and Assessment of Dysphagia and Aspiration
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Diffuse oesophageal spasm is a condition characterized by non-effective peristaltic waves of high amplitude in the oesophagus, causing angina-like chest pain. Barium swallow and manometry demonstrate non-propulsive peristaltic waves and incomplete lower oesophageal sphincter relaxation.
Case 63: A Young Woman with Chest Pain
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
Diffuse oesophageal spasm can present with moderate–severe chest pain, often mistaken for angina. Patients may have acute presentations or may develop chronic oesophageal spasm. Symptoms include odynophagia, regurgitation and vomiting. Acute viral infections are thought to be possible triggers for the onset of achalasia and diffuse oesophageal spasm. Glyceryl trinitrate and calcium channel antagonists may provide symptomatic relief.
Exploring the role of botulinum toxin in critical care
Published in Expert Review of Neurotherapeutics, 2021
Muhammad Ubaid Hafeez, Michael Moore, Komal Hafeez, Joseph Jankovic
The role of endoscopic BoNT injections has been well documented in treatment of achalasia [66] and other esophageal motility disorders including diffuse esophageal spasm (DES) and nutcracker esophagus [67]. These conditions can potentially lead to recurrent aspiration and increase pulmonary morbidity although literature on long-term outcomes is lacking [66,67]. Single case reports indicate benefit of BoNT in management of certain patients who develop ICU acquired post-extubation dysphagia (PED) [68–71]. PED is usually multifactorial with a higher incidence in advanced age, underlying neurological conditions and prolonged intubations [72]. Dysphagia associated with upper esophageal sphincter (UES) dysfunction in setting of acute ischemic stroke, intracranial hemorrhage or multiple sclerosis has been reported to improve after UES BoNT injections [68–71,73].
Autoimmune gastrointestinal dysmotility: the interface between clinical immunology and neurogastroenterology
Published in Immunological Medicine, 2021
Shunya Nakane, Akihiro Mukaino, Eikichi Ihara, Yoshihiro Ogawa
Previously, we have observed that Japanese females are predominantly affected by AAG with severe dysmotility [5]. Six of 123 seropositive AAG patients presented with achalasia or diffuse esophageal spasm as severe upper GI dysmotility in this study. The mean age and mean age at disease onset were 49.7 years and 37.8 years, respectively. A gradual mode of onset was more common, and the GI tract symptoms included various digestive system problems, such as appetite loss, nausea and/or vomiting, early satiety, and postprandial abdominal pain owing to the dysfunction of the upper digestive system, and diarrhea, constipation, alternate stool abnormality, and paralytic ileus owing to the dysfunction of the lower digestive system. Among the 123 patients with seropositive AAG, 4 patients had paralytic ileus, one of whom disclosed having gastroparesis as severe lower GI dysmotility. The mean age and mean age at disease onset were 63.5 years and 60.5 years, respectively. A gradual mode of onset was frequently observed and widespread dysfunction of the digestive system was common. Other autonomic symptoms (orthostatic hypotension/intolerance and bladder dysfunction) and extra-autonomic manifestations were observed in these 10 patients. In particular, regarding extra-autonomic manifestations, autoimmune diseases (Sjögren’s syndrome and primary biliary cirrhosis) were detected in 2 patients and gastric cancer was detected in 1 patient. Furthermore, we attempted to clarify the seroprevalence of gAChR AAbs in the patients with severe GI dysmotility in this previous study. We enrolled 28 patients with achalasia and 14 patients with IPO and detected anti-gAChR AAbs in 21.4% patients with achalasia and in 50.0% patients with chronic IPO. Although the patients with achalasia and chronic IPO demonstrated various autonomic dysfunction, bladder dysfunction was observed in the seropositive patients with chronic IPO as a prominent clinical characteristic of dysautonomia. The seropositive IPO group showed female predominance (71%). Two of seven cases of seropositive IPO had Sjögren’s syndrome and cancer of the uterine body. However, in our study, no significant difference was noted in the coexistence of autoimmune diseases and tumors between the seropositive and seronegative IPO groups.