1 / 17

Esophageal Motility Abnormalities

Abnormal Esophageal Motility Indications. Evaluation of patients with dysphagiaPrimary motility disordersAchalasiaSpastic disordersSecondary motility disordersSclerodermaIEMEvaluation of patients with GERDEvaluate peristalsis and LESGERD severityPrior to fundoplicationAssist in placement

ave
Download Presentation

Esophageal Motility Abnormalities

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Esophageal Motility Abnormalities

    2. Abnormal Esophageal Motility Indications Evaluation of patients with dysphagia Primary motility disorders Achalasia Spastic disorders Secondary motility disorders Scleroderma IEM Evaluation of patients with GERD Evaluate peristalsis and LES GERD severity Prior to fundoplication Assist in placement of pH probe Evaluation of patients with noncardiac chest pain

    3. Abnormal Esophageal Motility “Inadequate LES relaxation” Classic achalasia – idiopathic or secondary Atypical disorders of LES relaxation Uncoordinated motility Distal esophageal spasm Hypercontraction Body = nutcracker esophagus LES = hypertensive LES Hypocontraction Body = Ineffective esophageal motility (IEM) LES = Hypotensive LES

    4. Abnormal Esophageal Motility “Inadequate LES relaxation” Classic achalasia – idiopathic or secondary Atypical disorders of LES relaxation Uncoordinated motility Distal esophageal spasm Hypercontraction Body = nutcracker esophagus LES = hypertensive LES Hypocontraction Body = Ineffective esophageal motility (IEM) LES = Hypotensive LES

    5. Clinical Importance IEM, hypotensive LES: Usually indicates GERD “Important” information prior to fundoplication MII identifies function abnormality Abnormal Esophageal Motility

    6. Abnormal Esophageal Motility Clinical Importance Achalasia Establish diagnosis and direct therapy DES, nutcracker esophagus, hypertensive LES: Relation to Sx may not be clear Only suggests therapy (no pathology known)

    8. LES Elevated baseline >45mm Hg Incomplete relaxation RP>8 mm Hg Esophageal Body Absent peristalsis* Esophageal Motility Abnormalities Inadequate LES relaxation

    10. Manometric Features of Esophageal Motility Abnormalities LES May be abnormal Esophageal Body >10% simultaneous* Repetitive (>2 peaks) Prolonged duration (> 6 secs) Spontaneous contractions Intermittent normal peristalsis High amplitude not common

    13. Esophageal Motility Abnormalities Hypercontraction LES May be hypertensive Esophageal Body High amplitude (>180 mm Hg)* May be long duration (> 6 sec) Normal peristalsis

    16. Esophageal Motility Abnormalities Hypocontraction LES Normal or low Esophageal Body Low amplitude (> 20%) Normal peristalsis

More Related