Esophageal Motility Disorders Questions & Answers

Updated: Dec 29, 2017
  • Author: Eric A Gaumnitz, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
  • Print
Questions & Answers

Overview

What are esophageal motility disorders?

What is the anatomy of the tubular esophagus relevant to esophageal motility disorders?

What is the anatomy of the body of the esophagus relevant to esophageal motility disorders?

What is the role of esophageal peristalsis in esophageal motility disorders?

What is primary peristalsis in esophageal motility disorders?

What is secondary peristalsis in esophageal motility disorders?

What is tertiary peristalsis in esophageal motility disorders?

What is the spectrum of esophageal motility disorders?

What is the classic presentation of esophageal motility disorders?

How are esophageal motility disorders classified?

What causes primary esophageal motility disorders?

What is the pathophysiology of the primary esophageal motility disorders?

What is the pathophysiology of achalasia?

What are the effects of achalasia on extrinsic nerves?

What is the physiologic process of achalasia?

What are the effects of achalasia on the lower esophageal sphincter (LES) pressure?

What is the pathogenesis of spastic motility disorders of the esophageal body?

What is the pathophysiology of secondary esophageal motility disorders related to scleroderma?

What is the incidence of esophageal motility disorders in the US?

What is the incidence of esophageal motility disorders in spinal cord injury (SCI) in the US?

What is the incidence of esophageal motility disorders in patients with anorexia nervosa and endoscopic sclerotherapy?

What is the global incidence of esophageal motility disorders?

What are the racial predilections for esophageal motility disorders?

How does the incidence of esophageal motility disorders vary by sex?

Which age groups are at highest risk for esophageal motility disorders?

What is the prognosis of achalasia?

What is the prognosis of secondary esophageal motility disorders?

What is the prognosis of spastic esophageal motility disorders?

What is the morbidity of achalasia?

What is the morbidity of spastic esophageal motility disorders?

What is the morbidity of secondary esophageal motility disorders?

What are the possible complications of achalasia?

When does squamous cell carcinoma typically develop in achalasia?

What information about esophageal motility disorders should patients receive?

Presentation

Which patient history is characteristic of achalasia?

What is the typical history of weight loss in esophageal motility disorders?

What are the signs and symptoms of spastic esophageal motility disorders?

What is the typical history of dysphagia in patients with esophageal motility disorders?

What are the indications of ineffective acid clearance from the esophagus in esophageal motility disorders?

What are the forms of secondary esophageal motility disorder due to scleroderma?

What are the signs and symptoms of secondary esophageal motility disorders due to scleroderma?

What is the incidence of erosive esophagitis in secondary esophageal motility disorders due to scleroderma?

What causes dysphagia in secondary esophageal motility disorders due to scleroderma?

Which physical findings suggest primary esophageal motility disorders?

What should be included in the physical exam for suspected esophageal motility disorder?

DDX

How is the differential diagnoses of esophageal motility disorders determined?

How are mechanical obstructing lesions ruled out in the differential diagnosis of esophageal motility disorders?

What conditions should be included in the differential diagnoses of achalasia?

What is Chagas disease (American trypanosomiasis) and how is it differentiated from achalasia?

What is familiar adrenal insufficiency with alacrima?

What is pseudoachalasia?

How is achalasia diagnosed?

How is diffuse esophageal spasm (DES) differentiated from achalasia?

What are the differential diagnoses for Esophageal Motility Disorders?

Workup

What is the role of chest radiography in the diagnosis of esophageal motility disorders?

Which chest radiography findings suggest achalasia?

Which chest radiography findings suggest spastic esophageal motility disorders?

What is the role of esophagography in the workup of esophageal motility disorders?

What is the role of manometry in the workup of esophageal motility disorders?

Which manometric findings indicate achalasia?

Which manometric findings of the lower esophageal sphincter (LES) suggest esophageal motility disorders?

Which manometric findings suggest esophageal spastic motility disorders?

What is the role of ambulatory esophageal manometry in the workup of esophageal motility disorders?

What is the role of high-resolution manometry in the workup of esophageal motility disorders?

What is the efficacy of high-resolution manometry in the workup of esophageal motility disorders?

What is the role of endoscopy in the workup of esophageal motility disorders?

What are the benefits of endoscopy in the evaluation of esophageal motility disorders?

Which endoscopic findings are characteristic of achalasia?

What is the role of endoscopic ultrasonography in the workup of esophageal motility disorders?

Which histologic findings are characteristic of esophageal motility disorders?

Treatment

Which specialist consultations are needed for the treatment of esophageal motility disorders?

When is transfer to centers with experienced GI and surgical services indicated for esophageal motility disorders?

What outpatient monitoring is needed for esophageal motility disorders?

What are the treatment options for esophageal motility disorders?

What is the role of pharmacologic therapy in the treatment of esophageal motility disorders?

What is the role of smooth muscle relaxants in the treatment of esophageal motility disorders?

How is noncardiac chest pain treated in esophageal motility disorders?

What is the role of botulinum toxin injections in the treatment of esophageal motility disorders?

What are the disadvantages of botulinum toxin injection in the treatment of esophageal motility disorders?

What is the efficacy of botulinum toxin injection for the treatment of esophageal motility disorders?

What is the role of endoscopic therapy in the treatment of esophageal motility disorders?

What is the role of surgery in the treatment of esophageal motility disorders?

What is the role of Heller myotomy in the treatment of esophageal motility disorders?

What is the role of myotomy of the lower esophageal sphincter (LES) in the treatment of esophageal motility disorders?

What is the efficacy of myotomy of the lower esophageal sphincter (LES) for the treatment of esophageal motility disorders?

What are the possible complications of the Heller myotomy for treatment of esophageal motility disorders?

What is the efficacy of Heller myotomy in the treatment of achalasia?

What is the role of esophagectomy in the treatment of esophageal motility disorders?

What is the role of extended Heller myotomy in the treatment of esophageal motility disorders?

Which dietary modifications are used in the treatment of esophageal motility disorders?

Which activity modification are used in the treatment of esophageal motility disorders?

Medications

What is the role of medications in the treatment of esophageal motility disorders?

Which medications in the drug class Antiparasitic agents are used in the treatment of Esophageal Motility Disorders?

Which medications in the drug class Acetylcholine release inhibitors are used in the treatment of Esophageal Motility Disorders?

Which medications in the drug class Tricyclic antidepressants are used in the treatment of Esophageal Motility Disorders?

Which medications in the drug class Anxiolytics are used in the treatment of Esophageal Motility Disorders?

Which medications in the drug class Anticholinergics are used in the treatment of Esophageal Motility Disorders?

Which medications in the drug class Vasodilators are used in the treatment of Esophageal Motility Disorders?

Which medications in the drug class Calcium channel blockers are used in the treatment of Esophageal Motility Disorders?