Achalasia and Nonachalasia Esophageal Motility Disorders
Department of Pathophysiological Management/Medical Oncology, Graduate School of Medicine, Nippon Medical School
Dysphagia and chest pain often occur in adults, and most patients with persistent symptoms initially undergo evaluation to rule out reflux esophagitis, esophageal cancer, and cardiovascular disease. When the findings of these evaluations are normal, esophageal manometry is performed. Esophageal motility disorders, which include achalasia, diffuse esophageal spasm, nutcracker esophagus, hypertensive lower esophageal sphincter, and nonspecific esophageal motility disorder, are often identified in these patients. In our series, 78% of patients with nonobstructive dysphagia or unexplained (noncardiac) chest pain or both have an esophageal motility disorder (achalasia, 44%; diffuse esophageal spasm, 5%; nutcracker esophagus, 2%; and nonspecific esophageal motility disorder, 27%). Therefore, in patients who present with dysphagia or chest pain or both, an esophageal motility disorder should be suspected.
日医大医会誌 2009; 5(4), 202-206
achalasia, esophageal motility disorder, esophageal manometry
Katsuhiko Iwakiri, Department of Pathophysiological Management/Medical Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan