Title: Clinical disorders of oral, pharyngeal and esophageal motility : GI Motility online
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Synopsis
Clinical disorders of oral, pharyngeal and esophageal motility
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Motor Disorders of the Oral Cavity, Pharynx, and Cervical Esophagus
Motor Disorders of the Thoracic Esophagus and Lower Esophageal Sphincter ( LES)
Achalasia
Diffuse Esophageal Spasm
Hypertensive Peristalsis, Hypercontracting LES, and Hypertensive LES
Inappropriate Transient LES Relaxation
Hypotensive Esophagus
Ineffective Esophageal Clearance
Gastroesophageal Reflux Disease
Heartburn and Esophageal Chest Pain
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Content: Some cases of DES may progress to achalasia. The cause of the impairment is not found in many cases (idiopathic), but it is suspected that a large number of disorders, including stress, may cause inhibitory nerve dysfunction. Dysphagia to solids and liquids and chest pain are the usual presenting symptoms. The barium swallow may be normal or show nonpropagated contractions (also called tertiary contractions). In advanced cases the barium swallow may reveal a corkscrew esophagus and pseudodiverticula. The diagnosis is best made by an esophageal motility study. A diagnosis of DES is made when greater than 20% swallow-induced contractions are nonperistaltic. Occasional nonperistaltic contraction can occur normally. The amplitude of the nonperistaltic contractions may be increased or normal or even decreased. Sometimes contractions are multipeaked, and spontaneous contractions unassociated with swallowing may be present.