motility disorder Flashcards
1
Q
What is achalasia?
A
a - meaning without
chalasia - meaning relaxation
a failure of relaxation of the lower oesophageal sphincter OR inability of the lower 2/3s of the oesophagus to perform peristalsis
2
Q
What are the clinical features of achalasia?
A
- usually progressive dysphagia to solids then fluids
- regurgitation
- retrosternal pain
- weight loss
3
Q
What are the investigations + results confirming achalasia?
A
-barium swallow - bird beak sign
-oesophageal manometry - GOLD STANDARD
-measures oesophageal pressure - incomplete or
absent sphincter relaxation +/- decreased
peristalsis + widened oesophagus
-OGD - is suspicious of Ca can biopsy
CXR - widened mediastinum
4
Q
What are the treatment options for achalasia?
A
- pneumatic balloon dilation
- lower oesophageal sphincter myotomy
- LOS botox injection
- calcium channel blockers or nitrates
