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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
Esophageal motility disorders are produced by a variety of abnormalities in the coordinated neuromuscular components responsible for orderly peristalsis in the esophagus. The primary symptoms of esophageal motility disorders are dysphagia (difficulty with food transport down the esophagus) and chest pain. The underlying motor abnormalities are most readily diagnosed by careful esophageal manometric studies. It should be noted that, until the mid-1980s, our manometric techniques allowed us only to define achalasia and markedly diminished LES pressure. However, recent advances in technology now permit accurate recording of pressures generated in the esophageal body as well as in the upper and lower sphincters. Several laboratories have established criteria for normal esophageal contractile activity in studies of large numbers of healthy adults (45,46). In addition, newer esophageal motility disorders have been recognized, particularly in patients with chest pain of unknown etiology (see Table 2).
Esophageal Motility: Measures and Disorders of Esophageal Motor Function
Published in John F. Pohl, Christopher Jolley, Daniel Gelfond, Pediatric Gastroenterology, 2014
Based on this classification, achalasia is divided into three distinct types of achalasia (Table 6.4, 6.10–6.12). This classification only applies to primary esophageal motility disorders and is not intended to include postsurgical studies, for example after fundoplication or Heller myotomy.
Factors predictive of gastroesophageal reflux disease and esophageal motility disorders in patients with non-cardiac chest pain
Published in Scandinavian Journal of Gastroenterology, 2018
Juan Gomez Cifuentes, Rocio Lopez, Prashanthi N. Thota
Fifty five (31%) of the patients had an esophageal motility disorder when analyzed per Chicago classification v3.0. The most common diagnoses were IEM, jackhammer esophagus and DES in 14.1, 6.8 and 5.1%, respectively (Figure 1). Achalasia was diagnosed in four patients (type II in three and type III in one) and EGJ outflow obstruction in three patients. Patients diagnosed with hypertensive peristalsis disorders and achalasia/EGJ outflow obstruction were more likely to present with dysphagia (p ≤ .001). Conversely, patients with hypotensive peristalsis disorders present more often with heartburn (p = .010) and had higher total and upright abnormal esophageal acid exposure, (p = .020) and (p = .001), respectively (Table 2). When compared to patients with normal motility, patients with esophageal motility disorders were older (57.7 ± 12.7 versus 52.7 ± 12.7, p = .015) and were more likely to have dysphagia (54.5 versus 23%, p ≤ .001). No statistically significant differences were found between groups based on demographics, upper endoscopic findings, or ambulatory esophageal pH parameters.
Surgical resection of voluminous epiphrenic diverticula
Published in Acta Chirurgica Belgica, 2021
Vicky Maertens, Sjoerd Lagarde, Bas Wijnhoven
Esophageal diverticula are rare outpouchings of the esophagus which may be classified anatomically as pharyngeal (Zenker's), mid-esophageal and epiphrenic. In this article, we discuss epiphrenic pulsion diverticula, created by increased intraluminal pressure. The pathogenesis differs from mid-esophageal traction diverticula, caused by external force on the esophageal wall in pulmonary disease and mediastinal inflammation. Epiphrenic diverticula are usually false diverticula, including only (sub)mucosa, located in the distal esophagus. Diagnosis is made by upper gastrointestinal endoscopy in combination with barium swallow. Esophageal manometry is advised to evaluate possible underlying esophageal motility disorder.
Effectiveness of esophagogastroduodenoscopy in changing treatment outcome in refractory gastro-esophageal reflux disease
Published in Scandinavian Journal of Gastroenterology, 2022
Ye Eun Kwak, Ahmed Saleh, Ahmed Abdelwahed, Mayra Sanchez, Amir Masoud
Baseline information on age, gender, race/ethnicity, body mass index (BMI), alcohol consumption and cigarette consumption was collected. PPI treatment prior to EGD and duration of GERD symptoms were also identified. Patients with esophageal motility disorders were identified when the diagnosis was confirmed with appropriate diagnostic procedures. Connective tissue disorder was identified based on past medical history.