Esophageal motility disorder
An esophageal motility disorder (EMD) is any medical disorder resulting from dysfunction of the coordinated movement of esophagus, which causes dysphagia (i.e. difficulty in swallowing, regurgitation of food).[1]
| Esophageal motility disorder | |
|---|---|
| Other names | Esophageal dysmotility (ED) |
| Diagnostic method | Esophageal motility study Functional Lumen Imaging Probe |
| Treatment | treatment depends on cause |
Primary Motility Disorders are [1]:
- Achalasia
- Distal esophageal spasm
- Hypercontractile (jackhammer) esophagus
- Hypertensive LES
- Nutcracker (high-pressure) esophagus
An esophageal motility disorder can also be secondary to other diseases[1]. For example, it may be a result of CREST syndrome, referring to the five main features: calcinosis, Raynaud syndrome, esophageal dysmotility, sclerodactyly and telangiectasia.[2]
Symptoms
Symptoms of EMD can include chest pain, and intermittent dysphagia for solids, liquids, or both, and regurgitation.[3] Contractions along the lower esophagus prevent the passage of food.[4]
Types
Dysphagia could be for solids only, or for solids and liquids both.
- Solid dysphagia is due to obstructions such as esophageal cancer, esophageal webs, or stricture.
- Solid-and-liquid dysphagia is due to an esophageal motility disorder (or dysmotility) either in the upper esophagus (caused by, for example, myasthenia gravis, stroke, or dermatomyositis) or the lower esophagus (where causes include systemic sclerosis, CREST syndrome, or achalasia).
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.[5]
If there is a food allergy causing the dysmotility disorder, then physicians recommend an elimination diet. If this fails, then physicians will prescribe medication.
Diagnostics
Testing to diagnose EMD includes barium esophagography, upper endoscopy, and esophageal manometry.[6]
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.[6]
See also
References
- Goyal, Manjeet; Nagalli, Shivaraj (2023), "Esophageal Motility Disorders", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 32965826, retrieved 2023-10-20
- 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. PMID 14171636.
- Schlottmann, Francisco (2017). "Primary Esophageal Motility Disorders: Beyond Achalasia". International Journal of Molecular Sciences. 18 (7): 1399. doi:10.3390/ijms18071399. PMC 5535892. PMID 28665309.
- Medicine, UW. "Esophageal Motility Disorders - UW Medicine". www.uwmedicine.org. Archived from the original on 2018-09-27. Retrieved 2015-01-10.
- "Achalasia and Esophageal Motility Disorders". ctsurgerypatients.org. The Society of Thoracic Surgeons. Retrieved 16 November 2021.
- McQuaid, Kenneth (2022). Current Medical Diagnosis & Treatment 2022. McGraw Hill.
External links