An esophageal motility disorder (EMD) is any

medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...

disorder causing difficulty in

swallowing Swallowing, sometimes called deglutition in scientific contexts, is the process in the human or animal body that allows for a substance to pass from the mouth, to the pharynx, and into the esophagus, while shutting the epiglottis. Swallowing i ...

, regurgitation of food and a

spasm A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ such as the bladder. A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a muscle c ...

-type pain which can be brought on by an allergic reaction to certain foods. The most prominent one is

dysphagia Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or liq ...

. Esophageal motility disorder may be a result of

CREST syndrome CREST syndrome, also known as the limited cutaneous form of systemic sclerosis (lcSSc), is a multisystem connective tissue disorder. The acronym "CREST" refers to the five main features: calcinosis, Raynaud's phenomenon, esophageal dysmotility, ...

, referring to the five main features:

calcinosis Calcinosis is the formation of calcium deposits in any soft tissue. It is a rare condition that has many different causes. These range from infection and injury to systemic diseases like kidney failure. Types Dystrophic calcification The most c ...

Raynaud syndrome Raynaud syndrome, also known as Raynaud's phenomenon, eponymously named after the physician Auguste Gabriel Maurice Raynaud, who first described it in his doctoral thesis in 1862, is a medical condition in which the spasm of small arteries ca ...

, esophageal dysmotility,

sclerodactyly Sclerodactyly is a localized thickening and tightness of the skin of the fingers or toes that yields a characteristic claw-like appearance and spindle shape of the affected digits, and renders them immobile or of limited mobility. The thickened, ...

and

telangiectasia Telangiectasias, also known as spider veins, are small dilated blood vessels that can occur near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter. These dilated blood vessels can develop anywhere on ...

Symptoms

Symptoms of EMD can include chest pain, and intermittent Dysphagia for solids, liquids, or both, and regurgitation. There are contractions along the lower esophagus, and these contractions prevent the passage of food.

Types

Dysphagia Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or liq ...

could be for solids only, or for solids and liquids both. * Solid dysphagia is due to obstructions such as

esophageal cancer Esophageal cancer is cancer arising from the esophagus—the food pipe that runs between the throat and the stomach. Symptoms often include difficulty in swallowing and weight loss. Other symptoms may include pain when swallowing, a hoarse voi ...

, esophageal webs, or

stricture Stricture may refer to: * stricture (medicine), a narrowing of a tubular structure,. ** esophageal stricture A benign esophageal stricture, or peptic stricture, is a narrowing or tightening of the esophagus that causes swallowing difficulties. ...

. * Solid-and-liquid dysphagia is due to an esophageal motility disorder (or dysmotility) either in the upper esophagus (caused by, for example,

myasthenia gravis Myasthenia gravis (MG) is a long-term neuromuscular junction disease that leads to varying degrees of skeletal muscle weakness. The most commonly affected muscles are those of the eyes, face, and swallowing. It can result in double vision, ...

stroke A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...

, or

dermatomyositis Dermatomyositis (DM) is a long-term inflammatory disorder which affects skin and the muscles. Its symptoms are generally a skin rash and worsening muscle weakness over time. These may occur suddenly or develop over months. Other symptoms may inc ...

) or the lower esophagus (where causes include

systemic sclerosis Systemic scleroderma, or systemic sclerosis, is an autoimmune rheumatic disease characterised by excessive production and accumulation of collagen, called fibrosis, in the skin and internal organs and by injuries to small arteries. There are two ...

, CREST syndrome, or

achalasia Esophageal achalasia, often referred to simply as achalasia, is a failure of smooth muscle fibers to relax, which can cause the lower esophageal sphincter to remain closed. Without a modifier, "achalasia" usually refers to achalasia of the esoph ...

). The most common form of dysphagia is achalasia, which is caused by degeneration of the nerves in the esophagus. This causes the muscles to stop working and prevents the valve at the bottom of the esophagus from being able to open properly. If there is a food allergy causing the dysmotility disorder, then physicians recommend an elimination diet. If this fails, then physicians will prescribe special types of

medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...

to help resolve this problem.

Diagnostics

Testing to diagnose an EMD include: Barium Esophagography, Upper Endoscopy, and Esophageal Manometry.

Treatments

There is no cure for EMD, but symptoms can be managed. Some symptom management includes eating slower and taking smaller bites; in some cases medications can be useful to manage other issues that contribute to EMD such as a proton pump inhibitor to ease gastroesophageal reflux (acid reflux), or a smooth muscle relaxant for issues with the muscles.

References

External links