An esophageal motility disorder (EMD) is any
medical
Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...
disorder resulting from dysfunction of the coordinated movement of esophagus, which causes
dysphagia (i.e. difficulty in
swallowing,
regurgitation of food).
Primary motility disorders are:
*
Achalasia
*
Diffuse esophageal spasm
*
Nutcracker esophagus
Nutcracker esophagus, jackhammer esophagus, or hypercontractile peristalsis, is a disorder of the movement of the esophagus characterized by Peristalsis, contractions in the smooth muscle of the esophagus in a normal sequence but at an excessive ...
* Hypertensive lower esophageal sphincter
An esophageal motility disorder can also be secondary to other diseases.
For example, it may be a result of
CREST syndrome, referring to the five main features:
calcinosis,
Raynaud syndrome, esophageal dysmotility,
sclerodactyly and
telangiectasia.
[Winterbauer RH (1964). "Multiple telangiectasia, Raynaud's phenomenon, sclerodactyly, and subcutaneous calcinosis: a syndrome mimicking hereditary hemorrhagic telangiectasia". Bulletin of the Johns Hopkins Hospital 114: 31–83. .]
Symptoms
The most common symptom of esophageal motility disorders is
dysphagia. Compared to causes of mechanical obstruction, which usually coincide with difficulties only with solids, dysphagia occurs in both solid foods and liquids.
Heartburn
Heartburn is a burning sensation felt behind the breastbone. It is a symptom that is commonly linked to acid reflux and is often triggered by food, particularly fatty, sugary, spicy, chocolate, citrus, onion-based and tomato-based products. Ly ...
,
odynophagia,
chest pain, and
dyspnea are frequent symptoms of esophageal motility disorders, as they are in other
esophageal disorders. Advanced
achalasia is characterized by
regurgitation of previously swallowed, undigested food material. Individuals with
diffuse esophageal spasm or
nutcracker esophagus
Nutcracker esophagus, jackhammer esophagus, or hypercontractile peristalsis, is a disorder of the movement of the esophagus characterized by Peristalsis, contractions in the smooth muscle of the esophagus in a normal sequence but at an excessive ...
, due to disordered
peristalsis
Peristalsis ( , ) is a type of intestinal motility, characterized by symmetry in biology#Radial symmetry, radially symmetrical contraction and relaxation of muscles that propagate in a wave down a tube, in an wikt:anterograde, anterograde dir ...
propagation, may experience severe chest pain and dysphagia, mimicking
cardiac ischemia.
Achalasia's most common symptoms include dysphagia (difficulty swallowing solids and liquids), regurgitation of undigested food, respiratory issues (aspiration and nocturnal
cough
A cough is a sudden expulsion of air through the large breathing passages which can help clear them of fluids, irritants, foreign particles and Microorganism, microbes. As a protective reflex, coughing can be repetitive with the cough reflex fol ...
), chest pain, and
weight loss.
(DES) is a motility disorder characterized by recurrent episodes of chest pain or dysphagia as well as nonpropulsive (tertiary) contractions on
radiographs.
Nutcracker esophagus is characterized by high-amplitude peristaltic contractions that are frequently prolonged and cause dysphagia and chest pain.
HLES (hypertensive lower esophageal sphincter) is a rare manometric abnormality seen among individuals with dysphagia, chest pain,
gastroesophageal reflux, and
hiatal hernia.
Diagnosis
Testing to diagnose EMD includes
barium esophagography,
upper endoscopy, and
esophageal manometry.
Treatment
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.
See also
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Esophageal disease
*
Esophageal motility study
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Esophageal spasm
*
GERD
Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is a chronic upper gastrointestinal disease in which stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or ...
*
Nutcracker esophagus
Nutcracker esophagus, jackhammer esophagus, or hypercontractile peristalsis, is a disorder of the movement of the esophagus characterized by Peristalsis, contractions in the smooth muscle of the esophagus in a normal sequence but at an excessive ...
*
Esophagogastric junction outflow obstruction
*
Systemic sclerosis
*
Esophageal food bolus obstruction
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Dysphagia
*
Functional Lumen Imaging Probe
References
External links
{{DEFAULTSORT:Esophageal Motility Disorder
Diseases of oesophagus, stomach and duodenum
Esophagus disorders