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Related Concept Videos

Gastrointestinal Motility Disorders01:20

Gastrointestinal Motility Disorders

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Gastrointestinal or GI motility disorders are characterized by irregular gastrointestinal tract movements, disrupting food transit from the mouth to the anus. They are caused by damage or dysfunction in gut muscles or nerves. These disorders can cause symptoms such as severe constipation, diarrhea, abdominal pain, and swallowing difficulties. Disorders can affect any segment of the GI tract and range widely in severity, from common conditions like GERD to life-threatening conditions like...
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Gastric Motility01:16

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Gastric motility is the coordinated contraction and relaxation of stomach muscles that convert ingested food into chyme, a semi-liquid substance ready for further digestion in the intestines. The process begins with the vagus nerve inducing the relaxation of the smooth muscles in the fundus and body of the stomach, allowing these regions to expand and accommodate up to approximately 1.5 liters of food and liquid.
Peristaltic Waves and Chyme Formation
Upon food entry, the stomach initiates...
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Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists01:28

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Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...
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Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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Other Disorders of Digestive System01:30

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The gastrointestinal tract is susceptible to various disorders. If the lower esophageal sphincter is damaged, stomach acid can flow back into the esophagus, causing irritation and inflammation of the lining. This condition is called gastroesophageal reflux disease (known as heartburn) and may cause chest pain and difficulty swallowing. In the stomach, prolonged use of nonsteroidal anti-inflammatory drugs like aspirin, chronic alcohol consumption, bacterial infections such as Helicobacter...
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Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists01:23

Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists

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Serotonin, a crucial neurotransmitter synthesized by enterochromaffin cells, plays a cardinal role in regulating gastrointestinal (GI) motility. With over 90% of the body's total serotonin in the GI tract, its influence on digestive processes is profound. Serotonin is swiftly released upon various stimuli, such as food boluses or certain drugs, triggering intrinsic sensory neurons in the myenteric plexus and extrinsic vagal and spinal sensory neurons. This leads to the activation of the...
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Robotic Myotomy and Partial Fundoplication for Achalasia
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Esophageal Motility Disorders.

John M Wilkinson1, Magnus Halland1

  • 1Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

American Family Physician
|September 1, 2020
PubMed
Summary
This summary is machine-generated.

Esophageal motility disorders, like achalasia, require timely diagnosis for better outcomes. Overdiagnosis of hypercontractile disorders may lead to unnecessary interventions; many symptoms are functional esophageal disorders.

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Area of Science:

  • Gastroenterology
  • Esophageal Physiology
  • Diagnostic Medicine

Background:

  • Esophageal motility disorders present with symptoms like chest pain, heartburn, and dysphagia.
  • Diagnosis relies on esophageal manometry patterns, distinguishing achalasia from hypercontractile disorders.
  • Achalasia has clear diagnostic criteria and effective treatments, emphasizing timely diagnosis for improved patient outcomes.

Purpose of the Study:

  • To review the diagnosis and management of esophageal motility disorders.
  • To highlight potential overdiagnosis of hypercontractile motility disorders and functional esophageal disorders.
  • To differentiate achalasia from other motility issues and guide appropriate interventions.

Main Methods:

  • Review of diagnostic criteria for esophageal motility disorders.
  • Analysis of manometry patterns, including achalasia and hypercontractile disorders.
  • Discussion of differential diagnoses, including functional esophageal disorders and opioid-induced dysmotility.

Main Results:

  • Achalasia has objective criteria and benefits from timely diagnosis and treatment.
  • Hypercontractile motility disorders may be overdiagnosed, with many symptoms attributed to functional esophageal disorders.
  • Opioid-induced esophageal dysmotility is a growing concern that can mimic other conditions.

Conclusions:

  • Endoscopy is recommended for dysphagia, but specialized testing should follow optimal management of common conditions.
  • Invasive interventions are rarely needed for hypercontractile motility disorders, which are often benign.
  • Achalasia requires confirmation via high-resolution manometry and benefits from surgery or advanced endoscopic therapies.