Related Experiment Video
Updated: Jul 1, 2025
11:19
Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
1.5K
Approach to esophageal absent contractility: can we do better?
Amir Mari1, Sari Cohen2, Daniel L Cohen3
1Gastroenterology and Endoscopy Unit, Nazareth Hospital EMMS, Faculty of Medicine, Nazareth, Israel, Bar-Ilan University, Israel (Amir Mari, Tawfik Khoury).
Annals of Gastroenterology
|March 14, 2024
Summary
Absent contractility (AC), a rare esophageal motility disorder, lacks esophageal contractions but maintains sphincter relaxation. This review explores AC
Area of Science:
- Gastroenterology and Clinical Physiology
- Esophageal Motility Disorders
- Rheumatology and Autoimmune Diseases
Background:
- Absent contractility (AC) is a major esophageal peristalsis disorder identified by high-resolution manometry.
- It frequently co-occurs with autoimmune conditions like scleroderma and causes gastroesophageal reflux symptoms.
- AC significantly impacts patients, leading to complications such as esophagitis, candidiasis, Barrett's esophagus, and malnutrition.
Purpose of the Study:
- To provide a comprehensive understanding of absent contractility (AC), a significant esophageal motility disorder.
- To review recent advancements in the diagnosis and management of AC and its associated complications.
- To emphasize the necessity of a multidisciplinary approach for managing AC, considering individual patient presentations and underlying rheumatologic conditions.
Main Methods:
- This review synthesizes current knowledge on absent contractility (AC) through an in-depth evaluation of recent literature.
- It examines the diagnostic criteria, clinical manifestations, and common comorbidities of AC.
- The review assesses current and emerging therapeutic strategies for AC and its sequelae.
Main Results:
- Absent contractility (AC) is characterized by absent esophageal contractions with normal lower esophageal sphincter relaxation.
- The disorder is often associated with connective tissue diseases, particularly scleroderma, and presents with gastroesophageal reflux.
- Complications include erosive esophagitis, esophageal candidiasis, Barrett's esophagus, and malnutrition, necessitating comprehensive management.
Conclusions:
- Absent contractility (AC) is a distinct esophageal motility disorder requiring thorough understanding and management.
- A multidisciplinary approach, integrating clinical presentation and rheumatologic status, is crucial for effective AC treatment.
- While medical management of reflux is primary, surgical and endoscopic options are emerging for refractory cases.
Related Concept Videos
01:21Barrett Esophagus-II: Clinical Manifestations and Management
144
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
144
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
80
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
80
01:26Esophageal Strictures-II: Clinical Features and Management
69
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
69
01:28Esophageal Perforation-II: Clinical Manifestations and Management
61
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
61
01:30Esophageal Strictures-I: Introduction
91
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...
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...
91