Motility Disorders Flashcards
What should you enquire about in dysphagia?
Type of food (solid vs liquid) Pattern (progressive vs intermittent) Associated features (weight loss, regurg, cough
Two areas that dysphagia can occur?
Oropharyngeal
Oesophageal
What can cause dysphagia?
Benign stricture Malignancy Motility disorders Eosinophilia oesophagitis Extrinsic compression (eg lung cancer)
What is odyonphagia?
Pain with swallowing
Ix for dysphagia?
Oesophago-gastro-duodenoscopy (OGD)
Upper GI endoscopy (UGIE)
Contrast radiology
PH-metry
S+S of hypermotility
Severe, episodic chest pain
Maybe dysphagia
Often confused with MI/angina
What’s the appearance of a hypermotile oesophagus?
Corkscrew
Cause of hypermotility?
Idiopathic
Causes of hypomotility?
Associated with connective tissue disease, diabetes, neuropathy
Causes failure of LOS leading to heartburn reflux symptoms
What’s achalaisa?
Functional loss of the myenteric plexus ganglion cells in the distal oesophagus and LOS
Failure of LOS to relax
Risk factor for achalasia?
3rd to 5th decade
S+S of achalasia
Progressive dysphagia for solids
Weight loss
Chest pain
Regurg and chest infections
Tx for achalasia?
Nitrates, CCB
Botulinum toxin pneumatic balloon dilation
Pneumatic balloon dilation
Myotomy
Consequences of achalasia?
Aspiration pneumonia
Increased risk of squamous cell oesophageal carcinoma
Drugs which affect GI motility?
Pro kinetic agents= increase gut motility and gastric emptying
Antiemetics= effective against nausea and vomiting
Antimuscarinics/antispasmodics=direct smooth muscle relaxants
Anti-motility drugs
