Primary oesophageal motility disorders. Current therapeutic concepts

Area of Science:

• Gastroenterology
• Esophageal Motility Disorders

Background:

• Esophageal manometry identifies various motility disorders linked to chest pain and dysphagia.
• Classic disorders include achalasia and diffuse esophageal spasm.

Purpose of the Study:

• To review the diagnostic and therapeutic approaches for esophageal motility disorders.
• To discuss pharmacological and interventional treatments for these conditions.

Main Methods:

• Review of manometric techniques for diagnosing esophageal motility disorders.
• Analysis of treatment strategies for achalasia, diffuse esophageal spasm, and related conditions.

Main Results:

• Achalasia and diffuse esophageal spasm have distinct manometric findings and treatment protocols.
• Pharmacological agents (nitrates, anticholinergics, calcium antagonists) and interventions (dilation, myotomy) are employed.
• Emerging manometric techniques identify disorders like 'nutcracker' esophagus, often associated with reflux or psychiatric factors.

Conclusions:

• Effective management of esophageal motility disorders requires accurate manometric diagnosis.
• Treatment selection depends on the specific disorder, including pharmacological and surgical options.
• Addressing associated conditions like GERD and psychiatric disturbances is crucial for comprehensive care.