Esophageal Motility Disorders Flashcards
What is Dysphagia?
Difficultly in swallowing due to sensation of food sticking to the throat
What is Odynophagia?
Substernal pain on swallowing
What is Odynophagia most commonly associated with?
Infectious esophagitis
What is the best defined primary motility disorder?
Achalasia
Explain achalasia?
Loss of the inhibitory at the sphincter means the LES can’t relax, thus obstruction
What can we do to detect Achalasia?
Manometry shows elevated LES pressure at 40mm+
Clinical presentation of Achalasia?
Dysphasia, regurgitation, chest pain
Why do we do an endoscopy when suspicious of Achalasia?
To rule out differential diagnosis
What does a barium swallow test do?
Shows dilatation of the esophagus
What does Achalasia look like with a barium swallow?
A bird beak at the bottom
What do we prescribe to treat Achalasia?
Long term nitrates, and Ca+ blockers before eating to lower the LES pressure
Surgically we do a Pneumatic dilation to treat Achalasia, explain it
We place a cylindrical ballon at the LES to dilate it
Explain diffuse esophageal spasm (DES)
Phasic non propulsive contractions replace the normal peristalsis
What do DES patients present with?
Intermittent dysphagia and chest pain
What do we do to diagnose DES?
Barium study, because DES is characterized by tertiary contractions dubbed ‘corkscrew esophagus’
