[Emerging Issues in Esophageal Motility Diseases].

Area of Science:

• Gastroenterology
• Esophageal Pathophysiology
• Clinical Medicine

Background:

• Advances in technology and medical knowledge are revealing new esophageal diseases.
• Esophageal motility disorders are being redefined with high-resolution manometry, improving understanding of their pathogenesis.
• Opioid analgesics, increasingly used worldwide, can induce esophageal dysfunction mimicking spastic motor disorders.

Purpose of the Study:

• To review emerging issues in esophageal motility disorders.
• To discuss opioid-induced esophageal dysfunction, eosinophilic esophagitis with eosinophilic esophageal myositis, and lymphocytic esophagitis.
• To present current evidence and reports on these conditions.

Main Methods:

• Review of recent scientific literature and clinical reports.
• Analysis of diagnostic criteria for eosinophilic and lymphocytic esophagitis.
• Correlation of high-resolution manometry findings with clinical presentations.

Main Results:

• Opioid-induced esophageal dysfunction can mimic achalasia and esophagogastric junction outflow obstruction.
• Eosinophilic esophagitis, particularly eosinophilic esophageal myositis, may present as spastic motor disorders like jackhammer esophagus.
• The distinct entity of lymphocytic esophagitis remains under investigation, with its relationship to other esophageal diseases unclear.

Conclusions:

• Esophageal motility disorders encompass a spectrum of conditions, including iatrogenic and inflammatory causes.
• Accurate diagnosis requires integrating pathological examination, manometry, and clinical context.
• Further research is needed to clarify the pathogenesis and distinctness of emerging esophageal conditions like lymphocytic esophagitis.