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Esophageal spasm

Mouen A Khashab, Petros C Benias, Lee L Swanstrom
Peroral endoscopic myotomy (POEM) is an advanced endoscopic procedure classically performed for the treatment of achalasia. The procedure is based on principles of submucosal endoscopy and is comprised of a mucosal incision, submucosal tunneling, myotomy and mucosal closure. Multiple published studies that collectively include more than 6000 patients reported clinical success in more than 80-90% of patients. Recent literature also suggested durability of response over a medium-term follow-up. POEM is associated with a low rate of adverse events when performed by experienced operators...
February 15, 2018: 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
Young Kwan Cho, Seong Hwan Kim
Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus...
January 2018: Clinical Endoscopy
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
Teng Zhang, Julia Maclean, Michal Szczesniak, Paul P Bertrand, Harry Quon, Raymond K Tsang, Peter I Wu, Peter Graham, Ian J Cook
Objectives Dysphagia is common in total laryngectomees, with some symptoms suggesting esophageal dysmotility. Tracheoesophageal (TE) phonation requires effective esophagopharyngeal air passage. Hence, esophageal dysmotility may affect deglutition or TE phonation. This study aimed to determine (1) the characteristics of esophageal dysmotility in laryngectomees, (2) whether clinical history is sensitive in detecting esophageal dysmotility, and (3) the relationship between esophageal dysmotility and TE prosthesis dysfunction...
February 2018: Otolaryngology—Head and Neck Surgery
Xia Chen, Ping Li, Fei Wang, Guozhong Ji, Lin Miao, Sihong You
Aims and objectives: Gastroesophageal reflux disease (GERD) affects mental state and social activities. On the contrary, mental disorders may also play a crucial role in GERD symptoms. The purpose of the study was to analyze the data of Symptom Checklist 90-Revised (SCL-90-R) questionnaire from patients with persisting GERD and to explore the impact of psychological factors on them. Materials and methods: The patients accepted SCL-90-R questionnaire survey, following endoscopy, high-resolution manometry (HRM), and ambulatory impedance-pH monitoring...
July 2017: Euroasian Journal of Hepato-Gastroenterology
Hiroki Matsuura
No abstract text is available yet for this article.
September 21, 2017: American Journal of Medicine
N Aggarwal, R Lopez, S Gabbard, N Wadhwa, P Devaki, P N Thota
The classic manometric findings in systemic sclerosis are aperistalsis of the esophageal body with hypotensive lower esophageal sphincter. These changes contribute to gastroesophageal reflux disease in these patients. With widespread use of high-resolution esophageal manometry, diverse abnormalities are seen. The aim of this study is to characterize esophageal dysmotility in patients with systemic sclerosis undergoing high-resolution esophageal manometry and compare demographic features and diagnostic test results among patients with varying degrees of esophageal dysmotility...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
E Zheng, R M Gideon, J Sloan, P O Katz
Currently, the diagnosis of esophageal motility disorders is in part based upon a hierarchical algorithm in which abnormalities of the esophagogastric junction (EGJ) is prioritized. An important metric in evaluating the EGJ is the integrated relaxation pressure (IRP). Patients who do not have achalasia but are found to have an elevated IRP are diagnosed with EGJ outflow obstruction. It has been our observation that a subset of these patients also has a second named motility disorder and may also have abnormal bolus transit...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
X Tang, Y Ren, S Huang, X Zhang, W Gong
No abstract text is available yet for this article.
September 2017: Journal of Gastroenterology and Hepatology
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
W O A Rohof, A J Bredenoord
PURPOSE OF REVIEW: High-resolution manometry (HRM) is increasingly performed worldwide, to study esophageal motility. The Chicago classification is subsequently applied to interpret the manometric findings and facilitate a diagnosis of esophageal motility disorders. This review will discuss new insights regarding the diagnosis and management using the Chicago classification. RECENT FINDINGS: Recent studies have demonstrated that high-resolution manometry is superior to conventional manometry, and has a higher sensitivity to diagnose achalasia...
August 2017: Current Gastroenterology Reports
Shinwa Tanaka, Takashi Toyonaga, Fumiaki Kawara, Ian S Grimm, Namiko Hoshi, Hirofumi Abe, Yoshiko Ohara, Yoshinori Morita, Eiji Umegaki, Takeshi Azuma
BACKGROUND AND STUDY AIMS : Peroral endoscopic myotomy (POEM) is an evolving new treatment strategy for achalasia. Although several kinds of electrosurgical knives have been used in performing POEM, the best device has yet to be determined. The FlushKnife BT is a waterjet-emitting short needle-knife with a small ball tip (BT) that offers the potential to perform all aspects of POEM with a single device. In this study, we evaluated the safety and efficiency of the FlushKnife BT for POEM...
July 2017: Endoscopy International Open
Francisco Schlottmann, Marco G Patti
The best-defined primary esophageal motor disorder is achalasia. However, symptoms such as dysphagia, regurgitation and chest pain can be caused by other esophageal motility disorders. The Chicago classification introduced new manometric parameters and better defined esophageal motility disorders. Motility disorders beyond achalasia with the current classification are: esophagogastric junction outflow obstruction, major disorders of peristalsis (distal esophageal spasm, hypercontractile esophagus, absent contractility) and minor disorders of peristalsis (ineffective esophageal motility, fragmented peristalsis)...
June 30, 2017: International Journal of Molecular Sciences
Fermín Estremera-Arévalo, Eduardo Albéniz, María Rullán, Irene Areste, Rosa Iglesias, Juan José Vila
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. METHODS: A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined...
August 2017: Revista Española de Enfermedades Digestivas
Omesh Goyal, Monika Bansal, Ajit Sood
BACKGROUND: Data on the spectrum of esophageal motility disorders in Indian population are scarce. We aimed to study the symptomatic and manometric profile of patients with suspected esophageal motility disorders. METHODS: Consecutive patients with esophageal symptoms who underwent esophageal high-resolution manometry (HRM) from January 2010 to December 2014 were included in this retrospective analysis of prospectively acquired data. HRM was performed with 22-channel water-perfusion system and patients classified using Chicago classification v3...
May 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Taro Shibuki, Hiroharu Kawakubo, Kojiro Kawachi, Toshihiko Mizuta
No abstract text is available yet for this article.
2017: Internal Medicine
Shinpei Kawaguchi, Toshihisa Takeuchi, Yousuke Inoue, Yoshiaki Takahashi, Haruhiko Ozaki, Kazuhiro Ota, Satoshi Harada, Shoko Edogawa, Yuichi Kojima, Hiroshi Yamashita, Takumi Fukuchi, Kiyoshi Ashida, Kazuhide Higuchi
BACKGROUND/AIMS: High-resolution manometry (HRM) has been applied to assess esophageal motility disorders. However, the frequency and types of motility disorders in patients with dysphagia, which are frequently seen in clinical practice, are not clear. We evaluated latent esophageal motility disorders associated with dysphagia. METHODS: The study included patients without erosive esophageal mucosal damage and with dysphagia symptoms refractory to at least 8 weeks of standard-dose proton pump inhibitors...
2017: Digestion
F C Okeke, S Raja, K L Lynch, S Dhalla, M Nandwani, E M Stein, B Chander Roland, M A Khashab, P Saxena, V Kumbhari, N K Ahuja, J O Clarke
BACKGROUND: Esophagogastric junction (EGJ) outflow obstruction (EGJOO) is characterized by impaired EGJ relaxation with intact or weak peristalsis. Our aims were to evaluate: (i) prevalence, (ii) yield of fluoroscopy, endoscopy, and endoscopic ultrasound (EUS), (iii) outcomes, and (iv) whether this data differed based on quantitative EGJ relaxation. METHODS: Studies that met criteria for EGJOO were identified. Demographics, encounters, endoscopy, radiology, treatment decisions, and outcomes were extracted...
June 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
F Schlottmann, N J Shaheen, R D Madanick, M G Patti
The best-defined primary esophageal motor disorder is achalasia. However, symptoms such as dysphagia, regurgitation and chest pain can be caused by other esophageal motility disorders such as Diffuse Esophageal Spasm (DES), Nutcracker Esophagus (NE) and the Hypertensive Lower Esophageal Sphincter (HTN-LES). Most patients with DES and HTN-LES who complain of dysphagia improve after a myotomy. Patients with NE whose main complaint is chest pain, often do not have relief of the pain and can even develop dysphagia as a consequence of the myotomy...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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