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Jackhammer Esophagus: Current Concepts and Dilemmas
Sami R Achem1, Genaro Vazquez-Elizondo2, Ronnie Fass3
1Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.
Journal of Clinical Gastroenterology
|December 18, 2020
Summary
Jackhammer esophagus (JE) is a rare esophageal motility disorder causing hypercontractile peristalsis, often affecting women over 65. Its causes and optimal treatments remain largely unknown, posing a challenge for patient care.
Area of Science:
- Gastroenterology
- Esophageal Motility Disorders
Background:
- Jackhammer esophagus (JE) is a hypercontractile esophageal motility disorder.
- Over 500 cases reported, with prevalence of 0.42%-9% in patients with esophageal motility disorders.
- Most affected individuals are women (60.5%) with a mean age of 65.2 years.
Purpose of the Study:
- To review the current understanding of Jackhammer esophagus.
- To discuss its clinical presentation, associated conditions, and potential pathogenesis.
- To explore current treatment strategies and their limitations.
Main Methods:
- Literature review of reported cases and studies on Jackhammer esophagus.
- Analysis of patient demographics, symptoms, and associated conditions.
- Summary of therapeutic interventions and their reported efficacy.
Main Results:
- Common symptoms include dysphagia (62.8%), reflux (40%), and chest pain (36.4%).
- JE is associated with obesity, opioid use, lung transplantation, eosinophilic esophagitis, neoplasia, and systemic diseases.
- Progression to achalasia observed in some patients; treatment efficacy is largely anecdotal.
Conclusions:
- Jackhammer esophagus is a heterogeneous disorder with unknown etiology and pathogenesis.
- Treatment is challenging due to limited understanding and anecdotal evidence of efficacy.
- Further research is needed to elucidate mechanisms and establish evidence-based treatments.
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