Oesophageal Motility Disorders Flashcards
What is the difference between Hypermotility and Hypomotility?
Hyper = oesophageal spasm Hypo = failure of LOS mechanism
Hypermotility Symptoms
Chest Pain
Dysphagia
Hypermotility Investigations and Results
Barium swallow - corkscrew appearance
Manometry - uncoordinated and hypertonic contractions
Hypermotility Treatment
Smooth muscle relaxant
Hypomotility Symptoms
Heartburn and Reflux
Conditions associated with hypomotility
Diabetes, neuropathy, connective tissue disorder
What is Achalasia
Failure of LOS to relax
What causes Achalasia
Loss of myenteric plexus ganglionic cells in distal oesophagus and LOS
Achalasia Symptoms
PROGRESSIVE dysphagia Chest pain Regurgitation Weight loss Chest infection
Achalasia Investigation and Result
Manometry - High resting pressure of LOS and absent peristalsis in distal oesophagus
Achalasia Treatment: drugs and purpose
Nitrates
CCB’s
BTX (endoscopically)
All reduce LOS tone
Achalasia Treatment: procedures
Pneumatic balloon dilation - stretch/tears LOS
Myotomy - incision made in outer layer of LOS
Achalasia Complications
Aspiration pneumonia causing lung disease
Lead to cancer - squamous cell oesophageal carcinoma
