Disease relevance of Esophageal Motility Disorders

• The sera from patients with the CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) variation of the autoimmune disease scleroderma contain autoantibodies that specifically recognize the kinetochore by immunofluorescence [1].
• Of the other 73 patients, 2 had pharyngeal dysfunction, 24 had achalasia, 1 had diffuse esophageal spasms, 3 had "nutcracker esophagus," 30 had nonspecific esophageal motor disorders, and 13 had gastroesophageal reflux [2].
• In particular, a high frequency of anti-Fibrillin-1 was observed in Japanese patients with diffuse and limited scleroderma or CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) syndrome [3].
• Conclusions: In this preliminary study involving 14 patients, the oral calcium channel blocker, diltiazem, appeared to improve noncardiac chest pain associated with strong esophageal contraction, the nutcracker esophagus [4].
• Although only five children had a recent history suggestive of gastroesophageal reflux, 12 had histologic evidence of reflux esophagitis (including 1 with a peptic stricture, 1 with "nutcracker" esophagus, and 1 with esophageal dysmotility characteristic of Down's syndrome) and all responded clinically to antireflux therapy [5].

Psychiatry related information on Esophageal Motility Disorders

• After a mean follow-up of 49 months (range 24-76 months), the cause of chest pain in the problem group was identified as panic disorder in 9 patients (50%), gastroesophageal reflux in 6 (33%), esophageal dysmotility in 2 (11%), and gallstone disease in 1 (6%) [6].

High impact information on Esophageal Motility Disorders

• We studied the esophageal effects of nifedipine in 20 patients with achalasia (20 mg sublingually) and nine patients with high-amplitude peristaltic esophageal contractions (nutcracker esophagus) (20 mg orally) [7].
• Effect of isosorbide and hydralazine in painful primary esophageal motility disorders [8].
• These studies suggest that verapamil or other calcium channel blocking agents may be of potential use in the treatment of esophageal motility disorders associated with increased pressure [9].
• Increased amplitude of esophageal contractions on baseline manometry (68.2 +/- 10.3 mmHg) was the only characteristic discriminating these patients from normals (40.9 +/- 6.3 mmHg) and from patients with esophageal motility disorders (39.6 +/- 7.5 mmHg) [10].
• Diltiazem, 240-480 mg/day, was given to 4 patients with idiopathic or CREST-related (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias) calcinosis for 1-12 years [11].

Chemical compound and disease context of Esophageal Motility Disorders

• In the only prospective placebo-controlled trial using an anti-depressant, trazodone was superior to placebo in relieving symptoms in patients with a variety of esophageal motility disorders [12].
• In the late period (after 30 days), the spectrum includes strictures, irregular contour, mural defects, esophageal dysmotility, and luminal obstruction [13].
• Cyclosporine A-induced achalasia-like esophageal motility disorder in a liver transplant recipient: successful conversion to tacrolimus [14].
• Both acute and chronic ethanol consumption may cause esophageal dysmotility [15].
• Evaluation revealed esophageal dysmotility, worsening renal function, and elevated serum PA and N-acetylprocainamide (NAPA) concentrations [16].

Anatomical context of Esophageal Motility Disorders

• In patients with nutcracker esophagus, nifedipine decreased LES pressure by approximately 50% and contraction amplitude in the body of the esophagus by approximately 25% [7].

Gene context of Esophageal Motility Disorders

• METHODS: Pulmonary function parameters were compared between groups of patients with and without manometric evidence for SSc-induced esophageal dysmotility [17].
• Esophageal motility disorder and hypertrophic cardiomyopathy were diagnosed in 6 and 3 patients, respectively [18].
• Esophageal dysmotility, in particular "nutcracker esophagus," should be suspected in infants with the FG syndrome and screaming attacks [19].
• Antibodies to hn-RNP protein A1 in systemic lupus erythematosus: clinical association with Raynaud's phenomenon and esophageal dysmotility [20].
• Further studies of ALTE are needed to ascertain how frequently GER or esophageal dysmotility is responsible for ALTE [21].

Analytical, diagnostic and therapeutic context of Esophageal Motility Disorders

• Patients with MVP (13 female, one male; mean age 49 years) were more likely (P = 0.01) to have esophageal dysmotility, while acid perfusion was less likely (P < 0.05) to provoke their chest pain, than in patients without MVP [22].

References