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Esophageal hypertensive peristaltic disorders.
1Digestive Physiology, Hopsices Civils de Lyon, Hospital E Herriot, and Lyon I University, Lyon, France. roman.sabine@gmail.com
Neurogastroenterology and Motility
|January 18, 2012
Summary
Hypertensive esophageal motility disorders, including nutcracker esophagus and jackhammer esophagus, are now classified using high-resolution manometry. This updated classification distinguishes between hypercontractile esophagus and hypertensive peristalsis, aiding in diagnosis.
Area of Science:
- Gastroenterology
- Esophageal Physiology
- Diagnostic Manometry
Background:
- Esophageal motility abnormalities present distinct manometric findings compared to normal individuals.
- Accurate characterization of these abnormalities is crucial for diagnosis and management.
Purpose of the Study:
- To review and summarize conventional and high-resolution esophageal manometry criteria.
- To define and characterize hypertensive esophageal motility abnormalities.
Main Methods:
- Review of current literature on esophageal manometry.
- Analysis of criteria for conventional and high-resolution manometry.
- Comparison of classification schemes for esophageal hypertensive motility disorders.
Main Results:
- Conventional criteria include nutcracker esophagus and hypertensive/poorly relaxing lower esophageal sphincter (LES).
- High-resolution manometry introduces hypertensive peristalsis (mean DCI >5000) and hypercontractile esophagus (DCI >8,000).
- A separate category for impaired esophageal-gastric junction relaxation (LES pressure >15 mmHg) is defined.
Conclusions:
- Hypertensive motility disorders are heterogeneous, encompassing hypercontractile esophagus and hypertensive peristalsis.
- High-resolution manometry offers a refined classification system.
- Further research is needed to establish the clinical significance of the new classification.
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