Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry |
| |
Authors: | Harika Gorti Salih Samo Nikrad Shahnavaz Emad Qayed |
| |
Affiliation: | Harika Gorti, Department of Medicine, Atlanta Veteran Affairs Medical Center and Emory University School of Medicine, Atlanta, GA 30322, United StatesSalih Samo, Nikrad Shahnavaz, Emad Qayed, Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA 30303, United States |
| |
Abstract: | Distal esophageal spasm (DES) is a rare major motility disorder in the Chicago dassification of esophageal motility disorders (CC).DES is diagnosed by finding of≥20%premature contractions,with normal lower esophageal sphincter (LES)relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0.This feature differentiates it from achalasia type 3,which has an elevated LES relaxation pressure.Like other spastic esophageal disorders,DES has been linked to conditions such as gastroesophageal reflux disease,psychiatric conditions,and narcotic use.In addition to HRM,ancillary tests such as endoscopy and barium esophagram can provide supplemental information to differentiate DES from other conditions.Functional lumen imaging probe (FLIP),a new cutting-edge diagnostic tool,is able to recognize abnormal LES dysfunction that can be missed by HRM and can further guide LES targeted treatment when esophagogastric junction outflow obstruction is diagnosed on FLIP.Medical treatment in DES mostly targets symptomatic relief and often fails.Botulinum toxin injection during endoscopy may provide a temporary therapy that wears off over time.Myotomy through peroral endoscopic myotomy or via surgical Heller myotomy can provide long term relief in cases with persistent symptoms. |
| |
Keywords: | Distal esophageal spasm High-resolution manometry Esophagus Functional lumenal imaging probe Spastic achalasia Esophageal motility |
本文献已被 维普 等数据库收录! |
| 点击此处可从《World Journal of Clinical Cases》浏览原始摘要信息 |
|