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Primary esophageal motility disorders.

D G Adler¹, Y Romero

¹Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic, Rochester, Minn. 55905, USA.

Mayo Clinic Proceedings

|February 24, 2001

Summary

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Esophageal motility disorders like achalasia cause chest pain and dysphagia due to lower esophageal sphincter dysfunction. Spastic disorders are benign, often linked to reflux, and treated for symptom relief.

Area of Science:

Gastroenterology
Esophageal Physiology

Background:

Esophageal motility disorders present with chest pain and dysphagia.
Achalasia involves lower esophageal sphincter (LES) failure to relax and absent esophageal peristalsis.
Pseudoachalasia mimics achalasia but can stem from infections or malignancy.

Purpose of the Study:

To differentiate achalasia from spastic esophageal disorders.
To outline current treatment strategies for esophageal motility disorders.

Main Methods:

Review of clinical presentations and manometric findings.
Comparison of achalasia, pseudoachalasia, and spastic esophageal disorders.
Analysis of treatment options for different esophageal motility conditions.

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Main Results:

Achalasia is progressive and causes significant morbidity.
Spastic disorders (diffuse esophageal spasm, nutcracker esophagus, nonspecific esophageal motility disorder) are benign and nonprogressive.
Gastroesophageal reflux disease (GERD) may be implicated in spastic disorders.

Conclusions:

Achalasia requires distinct management due to its progressive nature.
Spastic esophageal disorders are managed symptomatically.
Accurate diagnosis is crucial for appropriate treatment of esophageal motility disorders.