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Esophageal spasm

N Nakajima, H Sato, K Takahashi, G Hasegawa, K Mizuno, S Hashimoto, Y Sato, S Terai
BACKGROUND: Histopathology of muscularis externa in primary esophageal motility disorders has been characterized previously. We aimed to correlate the results of high-resolution manometry with those of histopathology. METHODS: During peroral endoscopic myotomy, peroral esophageal muscle biopsy was performed in patients with primary esophageal motility disorders. Immunohistochemical staining for c-kit was performed to assess the interstitial cells of Cajal (ICCs)...
October 3, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Juan Putra, Kristen E Muller, Zilla H Hussain, Siddhartha Parker, Scott Gabbard, Elizabeth B Brickley, Brian E Lacy, Richard Rothstein, Mikhail Lisovsky
Lymphocytic esophagitis (LE) is a histologic pattern with no established clinical correlates in the majority of patients. The goal of this study was to evaluate the association between nonachalasia primary esophageal motility disorders (PEMD) and LE. Sixty-nine patients with PEMD and esophageal biopsies, including 22 with nutcracker esophagus, 33 with ineffective motility, and 14 with diffuse spasm, constituted the study group. The control group consisted of 70 patients with severe dysmotility-negative gastroesophageal reflux disease requiring referral for Nissen fundoplication...
August 11, 2016: American Journal of Surgical Pathology
Emanuele Luigi Carniel, Alessandro Frigo, Mario Costantini, Tommaso Giuliani, Loredana Nicoletti, Stefano Merigliano, Arturo N Natali
Recent technological advances in esophageal manometry allowed the definition of new classification methods for the diagnosis of disorders of esophageal motility and the implementation of innovative computational tools for the autonomic, reliable and unbiased detection of different disorders. Computational models can be developed aiming to interpret the mechanical behavior and functionality of the gastrointestinal tract and to summarize the results from clinical measurements, as high-resolution manometry pressure plots, into model parameters...
July 15, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
D Ang, M Hollenstein, B Misselwitz, K Knowles, J Wright, E Tucker, R Sweis, M Fox
BACKGROUND/AIMS: The Chicago Classification for diagnosis of esophageal motility disorders by high-resolution manometry (HRM) is based on single water swallows (SWS). Emerging data suggest that a "Rapid Drink Challenge" (RDC) increases sensitivity for motility disorders. This study establishes normal values and diagnostic thresholds for RDC in clinical practice. METHODS: Two cohort studies were performed in patients with dysphagia or reflux symptoms (development and validation sets)...
July 15, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Jan Martínek, Jun-Ichi Akiyama, Zuzana Vacková, Manuele Furnari, Edoardo Savarino, Teus J Weijs, Elen Valitova, Sylvia van der Horst, Jelle P Ruurda, Lucas Goense, George Triadafilopoulos
Exciting new developments-pharmacologic, endoscopic, and surgical-have arisen for the treatment of many esophageal diseases. Refractory gastroesophageal reflux disease presents a therapeutic challenge, and several new options have been proposed to overcome an insufficient effectiveness of proton pump inhibitors. In patients with distal esophageal spasm, drugs and endoscopic treatments are the current mainstays of the therapeutic approach. Treatment with proton pump inhibitors (or antireflux surgery) should be considered in patients with Barrett's esophagus, since a recent meta-analysis demonstrated a 71% reduction in risk of neoplastic progression...
July 8, 2016: Annals of the New York Academy of Sciences
Froukje B van Hoeij, Jan F Tack, John E Pandolfino, Joel M Sternbach, Sabine Roman, André J P M Smout, Albert J Bredenoord
In achalasia and spastic esophageal motility disorders, botulinum toxin (botox) injection is considered an effective and low-risk procedure for short-term symptom relief. It is mainly offered to medically high-risk patients. However, no analysis of risks of botox injections has been performed. To determine the incidence and risk factors of procedure-related complications after esophageal botox injections, we analyzed the records of all patients undergoing botox injection therapy for esophageal motility disorders at four university hospitals in Europe and North America between 2008 and 2014...
June 24, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Kazumasa Muta, Eikichi Ihara, Keita Fukaura, Osamu Tsuchida, Toshiaki Ochiai, Kazuhiko Nakamura
BACKGROUND AND AIM: Acotiamide is a newly developed prokinetic drug that is clinically used to treat functional dyspepsia (FD). The objective of this study was to assess the therapeutic effects of acotiamide in patients with esophageal motility disorders (EMDs). METHODS: Twenty-nine patients with both symptoms of FD and symptoms suspicious of EMDs were enrolled. Esophageal motility function was evaluated by high-resolution manometry before and after 2 weeks administration of acotiamide (100 mg) 3 times per day...
2016: Digestion
Qasim Aziz, Ronnie Fass, C Prakash Gyawali, Hiroto Miwa, John E Pandolfino, Frank Zerbib
Functional esophageal disorders consist of a disease category that present with esophageal symptoms (heartburn, chest pain, dysphagia, globus) not explained by mechanical obstruction (stricture, tumor, eosinophilic esophagitis), major motor disorders (achalasia, EGJ outflow obstruction, absent contractility, distal esophageal spasm, jackhammer esophagus), or gastroesophageal reflux disease (GERD). While mechanisms responsible are unclear, it is theorized that visceral hypersensitivity and hypervigilance play an important role in symptom generation, in the context of normal or borderline function...
February 15, 2016: Gastroenterology
Robert Bechara, Haruhiro Inoue
Peroral endoscopic myotomy (POEM) was first performed in 2008 as a novel treatment of achalasia. It is now performed globally, demonstrating the evolution of the first successful natural orifice transluminal endoscopic surgery (NOTES) procedure. There is extensive data demonstrating the safety and efficacy of POEM, and now long-term data has emerged demonstrating that the efficacy is durable. POEM is also being used to successfully treat diffuse esophageal spasm (DES) and jackhammer esophagus. With jackhammer esophagus and DES, inclusion of the lower esophageal sphincter in the myotomy minimizes the risk of symptom development from iatrogenic ineffective esophageal motility...
April 2016: Gastrointestinal Endoscopy Clinics of North America
M Barret, T V K Herregods, J M Oors, A J P M Smout, A J Bredenoord
BACKGROUND: In the past, ambulatory 24-h manometry has been shown useful for the evaluation of patients with non-cardiac chest pain (NCCP). With the diagnostic improvements brought by pH-impedance monitoring and high-resolution manometry (HRM), the contribution of ambulatory 24-h manometry to the diagnosis of esophageal hypertensive disorders has become uncertain. Our aim was to assess the additional diagnostic yield of ambulatory manometry to HRM and ambulatory pH-impedance monitoring in this patient population...
August 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Fernando Augusto Herbella, Priscila Rodrigues Armijo, Marco Giuseppe Patti
High resolution manometry changed several esophageal motility paradigms. The 3.0 Chicago Classification defined manometric criteria for named esophageal motility disorders. We present a pictorial atlas of motility disorders. Achalasia types, esophagogastric junction obstruction, absent contractility, distal esophageal spasm, hypercontractile esophagus (jackhammer), ineffective esophageal motility, and fragmented peristalsis are depicted with high-resolution manometry plots.
March 8, 2016: Einstein
Nikolas Eleftheriadis, Haruhiro Inoue, Haruo Ikeda, Manabu Onimaru, Roberta Maselli, Grace Santi
Peroral endoscopic myotomy (POEM) is an innovative, minimally invasive, endoscopic treatment for esophageal achalasia and other esophageal motility disorders, emerged from the natural orifice transluminal endoscopic surgery procedures, and since the first human case performed by Inoue in 2008, showed exciting results in international level, with more than 4000 cases globally up to now. POEM showed superior characteristics than the standard 100-year-old surgical or laparoscopic Heller myotomy (LHM), not only for all types of esophageal achalasia [classical (I), vigorous (II), spastic (III), Chicago Classification], but also for advanced sigmoid type achalasia (S1 and S2), failed LHM, or other esophageal motility disorders (diffuse esophageal spasm, nutcracker esophagus or Jackhammer esophagus)...
January 25, 2016: World Journal of Gastrointestinal Endoscopy
R Y Lim, H Mulcahy, D Keane
Swallow syncope is a rare form of situational syncope. We report a case of swallow syncope with invasive confirmation of esophageal hypertension (spasm) and invasive confirmation of a bradycardia mechanism. Awareness of this uncommon disorder is important as a treatable cause of syncope.
November 2015: Irish Medical Journal
Tomonori Kanaeda, Marehiko Ueda, Makoto Arai, Masayuki Ishimura, Takatsugu Kajiyama, Naotaka Hashiguchi, Masahiro Nakano, Yusuke Kondo, Yasunori Hiranuma, Arata Oyamada, Osamu Yokosuka, Yoshio Kobayashi
BACKGROUND: Pulmonary vein isolation (PVI) has become an important option for treating patients with atrial fibrillation (AF). Periesophageal nerve (PEN) injury after PVI causes pyloric spasms and gastric hypomotility. This study aimed to clarify the impact of PVI on gastric motility and assess the prevalence of gastric hypomotility after PVI. METHODS: Thirty consecutive patients with AF underwent PVI under luminal esophageal temperature (LET) monitoring. The (13)C-acetate breath test was conducted before and after the procedure for all patients (PVI group)...
December 2015: Journal of Arrhythmia
M Wirth, C Bonnemains, J Auger, E Raffo, B Leheup
Sandifer's syndrome is a dystonic movement disorder in infants with gastroesophageal reflux (GER). It is probably misdiagnosed as epileptic seizures. We report the case of a 5-month-old infant with no past medical history admitted to a pediatric unit for suspicion of infantile spasms. She presented with dystonic movements of the upper left limb with left blepharospasm and an occasional dystonic head posture. Physical examination, EEG, brain MRI, and blood analysis were normal. Since the baby experienced regurgitations, Sandifer's syndrome was suspected and confirmed by 24-h esophageal pH monitoring that documented pathological GER...
February 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
I Marin, J Serra
BACKGROUND: Multiple rapid swallow has been proposed as a challenge test that can help diagnosis and management of patients with esophageal motility disorders. Our aim was to characterize specific pressure patterns in response to a rapid drink challenge test in patients with esophageal motility disorders, and to determine the potential of these patterns in the diagnosis of patients with esophageal symptoms but normal single swallow manometry. METHODS: Pressure responses to a rapid drink challenge test (rapid swallow of 200 mL water) were prospectively analyzed in 30 healthy controls and 285 patients with esophageal symptoms: 33 achalasia, 68 hypocontractile motility, 27 hypercontractile motility and 160 patients with normal manometry...
April 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Yoshimasa Tanaka, Eikichi Ihara, Kazuhiko Nakamura, Kazumasa Muta, Keita Fukaura, Koji Mukai, Xiaopeng Bai, Ryoichi Takayanagi
BACKGROUND AND AIM: Esophageal motility disorders (EMDs) affect coordinated esophageal contractility. Recent developments in high-resolution manometry have improved diagnosis of EMDs; however, the etiology of EMDs remains to be determined. This study aimed to determine which clinical characteristics are associated with esophageal motility. METHODS: From May 2013 to July 2014, 97 patients (54 women, 43 men; age, 16-89 years) with suspected EMDs were assessed by high-resolution manometry in Kyushu University Hospital...
June 2016: Journal of Gastroenterology and Hepatology
Juan Carlos Molano, Natalia Cortés, Efraín Noguera
INTRODUCTION: Munchhausen's syndrome is the best-studied type of factitious disorder with predominantly physical signs and symptoms. However, its clinical presentation during pregnancy is rare and literature on the subject is scarce. OBJECTIVE: To present a case of factitious disorder during pregnancy. METHOD: Review and analysis of a clinical case. RESULTS: The case of a 30-year-old woman six weeks pregnant who consults on multiple occasions with emesis and abdominal pain is discussed...
June 2012: Revista Colombiana de Psiquiatría
H U De Schepper, F A M Ponds, J M Oors, A J P M Smout, A J Bredenoord
BACKGROUND: According to the Chicago classification of esophageal motility disorders, distal esophageal spasm (DES) is defined as premature esophageal contractions (distal latency [DL] <4.5 s) for ≥20% of swallows, in the presence of a normal mean integral relaxation pressure (IRP). However, some patients with symptoms of DES have rapid contractions with a normal DL. The aim of this study was to characterize these patients and compare their clinical characteristics to those of patients classified as DES...
February 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
P Rossi, S Isoldi, S Mallardo, G Biscione, S Oliva, D Rossetti, S Lucarelli, S Cucchiara
BACKGROUND: Patients (pts) with eosinophilic esophagitis (EoE), a chronic immune-mediated disorder, may exhibit symptoms of disturbed food transit (i.e. dysphagia, impaction) or mimicking gastro-oesophageal reflux (GOR). We aimed at characterizing in EoE pts the intra-esophageal pH pattern with 24-h multichannel intraluminal impedance (MII-pH) as well as the esophageal motility with high-resolution manometry (EHRM) METHODS:: during a 30 month period we studied 57 patients (pts), median age 11 years (range: 7-16): 25 with EoE, diagnosed according to widely agreed criteria (JPGN 2014;58:107-18; ESPGHAN guidelines) and 32 with GOR disease (GORD)...
October 2015: Journal of Pediatric Gastroenterology and Nutrition
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