Title: Esophageal dysmotility, esophageal motility disorder, causes, symptoms, diagnosis & treatment
Headings: Esophageal dysmotility
Esophageal dysmotility
Esophageal motility disorder
Esophagus anatomy
Figure 1. Esophagus
Figure 2. Esophagus anatomy
Figure 3. Cross section view of the esophagus
Esophagus physiology
Figure 4. How the esophagus works
Upper esophageal sphincter
Peristalsis
Lower esophageal sphincter
Esophageal motility disorder causes
Primary esophageal causes of esophageal dysmotility include:
Systemic disorders causing esophageal dysmotility include:
Esophageal motility disorder symptoms
Achalasia
Spastic esophageal motility disorders
Scleroderma esophagus
Esophageal motility disorder diagnosis
Esophageal motility disorder treatment
Esophageal strictures treatment
Achalasia treatment
Medications
Botulinum toxin injection
Mechanical dilation
Surgery
Common pitfalls and side-effects of management
Esophageal motility disorder prognosis
Achalasia
Scleroderma esophagus
Spastic esophageal motility disorders
Mortality and morbidity
Complications
Achalasia and squamous cell carcinoma
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Content: Diffuse esophageal spasm is characterized by uncoordinated or simultaneous contractions of the esophagus with abnormal peristalsis following swallowing. The other disorders may show abnormalities in the amplitude, frequency or duration of contractions and/or a hypertensive lower esophageal sphincter. One subgroup of spastic disorders is “nutcracker esophagus”, characterized by contractions of high amplitude with otherwise normal peristalsis. Presenting symptoms of all hypermotility disorders include chest pain (in 80-90% of cases), dysphagia, regurgitation, and heartburn. A barium swallow and/or manometry are the preliminary diagnostic tests. The significance of these disorders is not fully understood however, as abnormal results can be seen in patients with and without symptoms, and the pain may not be directly attributable to dysmotility. Fortunately, these spastic disorders are not typically progressive or fatal. Treatment risks must therefore be especially weighed against potential benefits, with consideration of low-risk treatments (e.g., proton pump inhibitor to rule out possible GERD) first. Other options range from swallowing warm liquids with meals to invasive treatments used for achalasia (see below). Bougienage and serial dilation with increasing sizes of bougies may be effective for some patients.