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Esophagus motility disorders

Sven Höhne, Viola Hesse
The manometry with water-perfused or solid-state catheters is the predominant diagnostic procedure to detect motility disorders of the esophagus. Another method is the manometry using gas-perfused catheters. Although the high-resolution manometry is the method of first choice, the conventional manometry with helium has some advantages: the simple and hygienically unproblematic use and the absence of any artefacts by the perfusion medium compared with water-perfusion, and the considerably lower costs compared with the solid-state catheters...
February 2018: Medicine (Baltimore)
Marcus Joachim Herzig, Radu Tutuian
Esophageal achalasia is a primary smooth muscle motility disorder specified by aperistalsis of the tubular esophagus in combination with a poorly relaxing and occasionally hypertensive lower esophageal sphincter (LES). These changes occur secondary to the destruction of the neural network coordinating esophageal peristalsis and LES relaxation (plexus myentericus). There are limited data on segmental involvement of the esophagus in adults. We report on the case of a 54-year-old man who presented initially with complete aperistalsis limited to the distal esophagus...
2018: Clujul Medical (1957)
Dennis Yang, Peter V Draganov
OPINION STATEMENT: "Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa. Peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), and submucosal tunneling endoscopic resection (STER) are innovative techniques within the field of third space endoscopy in the management of esophageal disorders...
March 2018: Current Treatment Options in Gastroenterology
Constanza Ciriza de Los Ríos, Fernando Canga Rodríguez-Valcárcel, Alicia de Pablo Gafas, Isabel Castel de Lucas, David Lora Pablos, Gregorio Castellano Tortajada
BACKGROUND: lung transplantation (LTx) is a viable option for most patients with end-stage lung diseases. Esophageal motor disorders (EMD) are frequent in candidates for LTx, but there is very little data about changes in esophageal motility post-LTx. AIM: the aim of our study was to assess esophageal motor disorders by high resolution manometry (HRM) both pre-LTx and six months post-LTx in patients with and without organ rejection. STUDY: HRM (Manoscan®) was performed in 57 patients both pre-LTx and six months post-LTx...
February 9, 2018: Revista Española de Enfermedades Digestivas
Santiago Panesso-Gómez, Paula Pavia, Iván Enrique Rodríguez-Mantilla, Paola Lasso, Luis A Orozco, Adriana Cuellar, Concepción J Puerta, Belén Mendoza de Molano, John M González
Achalasia is a motility disorder of the esophagus that might be secondary to a chronic Trypanosoma cruzi infection. Several studies have investigated esophageal achalasia in patients with Chagas disease (CD) in Latin America, but no related studies have been performed in Colombia. The goals of the present study were to determine the presence of anti-T. cruzi antibodies in patients with esophageal achalasia who visited a referral hospital in Bogotá, Colombia, and to detect the presence of the parasite and its discrete typing units (DTUs)...
February 5, 2018: American Journal of Tropical Medicine and Hygiene
Mohan Ramchandani, D Nageshwar Reddy, Zaheer Nabi, Radhika Chouhan, Amol Bapaye, Shobhna Bhatia, Nilay Mehta, Pankaj Dhawan, Adarsh Chaudhary, Uday Ghoshal, Mathew Philip, Horst Neuhaus, Jacques Deviere, Haruhiro Inoue
Achalasia cardia (AC) is a frequently encountered motility disorder of the esophagus resulting from an irreversible degeneration of neurons. Treatment modalities are palliative in nature and there is no curative treatment available for AC as of now. Significant advancements have been made in the management of AC over last decade. The introduction of high resolution manometry (HRM) and per-oral endoscopic myotomy (POEM) have strengthened the diagnostic and therapeutic armamentarium of AC. HRM allows for the characterization of the type of achalasia which in turn has important therapeutic implications...
January 29, 2018: Journal of Gastroenterology and Hepatology
Sobia Laique, Tavankit Singh, David Dornblaser, Abhishek Gadre, Vikram Rangan, Ronnie Fass, Donald Kirby, Soumya Chatterjee, Scott Gabbard
GOALS: This study was carried out to assess the clinical characteristics and associated systemic diseases seen in patients diagnosed with absent contractility as per the Chicago Classification version 3.0, allowing us to propose a diagnostic algorithm for their etiologic testing. BACKGROUND: The Chicago Classification version 3.0 has redefined major and minor esophageal motility disorders using high-resolution esophageal manometry. There is a dearth of publications based on research on absent contractility, which historically has been associated with myopathic processes such as systemic sclerosis (SSc)...
January 19, 2018: Journal of Clinical Gastroenterology
C A Gutschow, H Schmidt
Diverticula of the middle and lower third of the esophagus are commonly associated with esophageal motility disorders. The increase of intraluminal pressure leads to an outpouching of the mucosal and submucosal layers through the esophageal muscle coat. These pouches are also called false diverticula, because they only consist of the mucosal and submucosal esophageal layers. In contrast, the more rarely encountered true diverticula that retain the complete esophageal wall are generally associated with periesophageal granulomatous lymph node disease...
January 18, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
András Vereczkei, Laura Bognár, András Papp, Örs Péter Horváth
Achalasia is a motility disorder of the esophagus characterized by the defective peristaltic activity of the esophageal body and impaired relaxation of the lower esophageal sphincter due to the degeneration of the inhibitory neurons in the myenteric plexus of the esophageal wall. The histopathological and pathophysiological changes in achalasia have been well described. However, the exact etiological factors leading to the disease still remain unclear. Currently, achalasia is believed to be a multifactorial disease, involving both extrinsic and intrinsic factors...
2018: Therapeutics and Clinical Risk Management
J Liu, Y Jiao, Y Niu, L Yu, M Ji, S Zhang
Esophageal achalasia is a type of motility disorder characterized by incomplete relaxation of lower esophageal sphincter (LES) and absence of esophageal peristalsis. Peroral endoscopic myotomy (POEM) is a new treatment option for achalasia that is less invasive, more effective, and safe as compared to surgery. High-frequency electrotome is commonly used in POEM, but takes longer time to make the tunnel in the esophagus and causes many complications. The thulium laser decreases the risk of bleeding and perforation in endoscopy but has not been reported in digestive diseases, especially in POEM...
January 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Fraukje Anna-Marie Ponds, André J P M Smout, Paul Fockens, Albert J Bredenoord
OBJECTIVE: Distal esophageal spasm (DES) is a rare motility disorder characterized by premature and rapidly propagated contractions of the distal esophagus. Treatment options are limited and often poorly effective. Peroral endoscopic myotomy (POEM) seems an effective and attractive new treatment option for DES. In this case report we describe some of the difficulties that could arise. MATERIALS AND METHODS: A 84-year old man with therapy-refractory DES and complaints of severe dysphagia and chest pain underwent a POEM procedure under general anesthesia...
March 2018: Scandinavian Journal of Gastroenterology
Constantine Fisher, Frances Puello, Samson Ferm, Moshe Rubin, H Alan Schnall
Achalasia is a disorder of the esophagus characterized by decreased lower esophageal sphincter (LES) relaxation and absence of esophageal peristalsis. Botulinum toxin (BT) injection targeting the LES has been used in the treatment of achalasia and other esophageal motility disorders, and it is considered to be safe and effective for short-term symptomatic relief. Serious adverse events of this procedure are rare. We report the case of an 83-year-old woman treated with BT injection for achalasia who subsequently developed a subdiaphragmatic abscess...
2017: ACG Case Reports Journal
K D Pham, R F Havre, T Langø, E F Hofstad, G A Tangen, R Mårvik, T Pham, O H Gilja, J G Hatlebakk, A Viste
BACKGROUND: In achalasia, muscle spasm may involve the proximal esophagus. When the muscle spasm is located in the proximal esophagus, conventional per oral endoscopic myotomy (POEM) may not be sufficient to relieve symptoms. In this paper, we describe retrograde endoscopic myotomy (REM) as a novel approach to perform myotomy of the proximal esophagus, with the application of a navigation tool for anatomical guidance during REM. We aim to evaluate the feasibility and safety of REM and usefulness of the navigation during REM...
November 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Rick Kellerman, Thomas Kintanar
Gastroesophageal reflux disease (GERD) is a gastrointestinal motility disorder that results from the reflux of stomach contents into the esophagus or oral cavity resulting in symptoms or complications. The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. GERD affects quality of life and may cause erosive esophagitis, esophageal strictures, and Barrett esophagus, a precursor to esophageal adenocarcinoma. GERD is a clinical diagnosis and is most effectively treated with proton-pump inhibitors (PPIs)...
December 2017: Primary Care
Jonathan Gotfried, Rahul Kataria, Ron Schey
The endocannabinoid system (ECS) primarily consists of cannabinoid receptors (CBRs), endogenous ligands, and enzymes for endocannabinoid biosynthesis and inactivation. Although the presence of CBRs, both CB1 and CB2, as well as a third receptor (G-protein receptor 55 [GPR55]), has been established in the gastrointestinal (GI) tract, few studies have focused on the role of cannabinoids on esophageal function. To date, studies have shown their effect on GI motility, inflammation and immunity, intestinal and gastric acid secretion, nociception and emesis pathways, and appetite control...
2017: Cannabis and Cannabinoid Research
Antonio Carlos Valezi, Fernando Augusto Herbella, Jorge Mali-Junior, Mariano de Almeida Menezes, Mário Liberatti, Rafael Onuki Sato
BACKGROUND: Sleeve gastrectomy may alter esophageal motility and lower esophageal sphincter pressure. AIM: To detect manometric changings in the esophagus and lower esophageal sphincter before and after sleeve gastrectomy in order to select patients who could develop postoperative esophageal motilitity disorders and lower esophageal sphincter pressure modifications. METHODS: Seventy-three patients were selected. All were submitted to manometry before the operation and one year after...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Roberto Monreal-Robles, José M Remes-Troche
Chronic hyperglycemia is a well-known cause of gastrointestinal motility disorders extending from the esophagus to the anorectum. Even though little attention has been paid to esophageal disorders in the context of DM, its prevalence is higher compared to gastroparesis. Heartburn, as a typical symptom of gastroesophageal reflux disease (GERD), is the most prevalent symptom and has been found in 25 to 41% of patients with DM. Furthermore, DM has recently been established as possible independent factor for the development of Barrett's esophagus...
December 2017: Current Treatment Options in Gastroenterology
Julian Kreiser, Alexander Hann, Eugen Zizer, Timo Ropinski
High-resolution manometry is an imaging modality which enables the categorization of esophageal motility disorders. Spatio-temporal pressure data along the esophagus is acquired using a tubular device and multiple test swallows are performed by the patient. Current approaches visualize these swallows as individual instances, despite the fact that aggregated metrics are relevant in the diagnostic process. Based on the current Chicago Classification, which serves as the gold standard in this area, we introduce a visualization supporting an efficient and correct diagnosis...
January 2018: IEEE Transactions on Visualization and Computer Graphics
William C Kethman, Chad M Thorson, Tiffany J Sinclair, William E Berquist, Stephanie D Chao, James K Wall
BACKGROUND: Achalasia is a primary esophageal motility disorder characterized by aperistalsis of the esophagus and failed relaxation of the lower esophageal sphincter that presents rarely in childhood. The peroral endoscopic myotomy (POEM) procedure is an emerging treatment for achalasia in adults that has recently been introduced into pediatric surgical practice. METHODS: This is a prospective case series of all children referred to Stanford University Lucile Packard Children's Hospital with manometry-confirmed achalasia who underwent a POEM procedure from 2014 to 2016...
August 9, 2017: Journal of Pediatric Surgery
Koji Otani, Shinwa Tanaka, Fumiaki Kawara, Junichi Fujikawa, Akinari Sawada, Risa Uemura, Tetsuya Tanigawa, Toshio Watanabe, Takeshi Azuma, Yasuhiro Fujiwara
Distal esophageal spasm (DES) is a primary esophageal motility disorder. We encountered a rare case of DES accompanied by multiple esophageal diverticula. A 72-year-old woman complained of prolonged dysphagia and chest pain. A barium esophagogram showed multiple esophageal diverticula and significant contraction of the lower esophagus just above the cardia. Esophagogastroduodenoscopy revealed a corkscrew-like appearance, with spiral contractions and diverticula. High-resolution manometry revealed that the integrated relaxation pressure was normal; premature contractions were observed in ≥20% of the swallowing wave; the distal contractile integral was normal...
October 2017: Clinical Journal of Gastroenterology
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