(See also Overview of Esophageal and Swallowing Disorders Overview of Esophageal and Swallowing Disorders The swallowing apparatus consists of the pharynx, upper esophageal (cricopharyngeal) sphincter, the body of the esophagus, and the lower esophageal sphincter (LES). The upper third of the esophagus... read more .)
Primary esophageal causes of dysmotility include
Systemic disorders causing esophageal dysmotility include
Many generalized disorders of neuromuscular function (eg, myasthenia gravis
Myasthenia Gravis
Myasthenia gravis involves episodic muscle weakness and easy fatigability caused by autoantibody- and cell-mediated destruction of acetylcholine receptors. It is more common among young women...
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, amyotrophic lateral sclerosis
Amyotrophic Lateral Sclerosis (ALS) and Other Motor Neuron Diseases (MNDs)
Amyotrophic lateral sclerosis and other motor neuron diseases are characterized by steady, relentless, progressive degeneration of corticospinal tracts, anterior horn cells, bulbar motor nuclei...
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, stroke
Overview of Stroke
Strokes are a heterogeneous group of disorders involving sudden, focal interruption of cerebral blood flow that causes neurologic deficit. Strokes can be Ischemic (80%), typically resulting...
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, Parkinson disease
Parkinson Disease
Parkinson disease is a slowly progressive, degenerative disorder characterized by resting tremor, stiffness (rigidity), slow and decreased movement (bradykinesia), and eventually gait and/or...
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) can affect swallowing but are not typically classified as esophageal motility disorders because they largely cause oropharyngeal dysphagia and not esophageal dysphagia.
Symptoms of esophageal motility disorders depend on the cause but typically include difficulty swallowing (dysphagia), chest pain, and/or heartburn.
Evaluation of esophageal motility disorders depends on the patient's presenting symptoms and may include upper gastrointestinal endoscopy
Endoscopy
Flexible endoscopes equipped with video cameras can be used to view the upper gastrointestinal tract from pharynx to proximal duodenum and the lower gastrointestinal tract from anus to cecum...
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, barium swallow
X-Ray and Other Imaging Contrast Studies of the Gastrointestinal Tract
X-ray and other imaging contrast studies visualize the entire gastrointestinal tract from pharynx to rectum and are most useful for detecting mass lesions and structural abnormalities (eg, tumors...
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, esophageal manometry
Esophageal manometry
Manometry is measurement of pressure within various parts of the gastrointestinal tract. It is done by passing a catheter containing solid-state or liquid-filled pressure transducers through...
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, acid- and reflux-related tests
Ambulatory pH Monitoring
Ambulatory 24-hour esophageal pH monitoring with or without intraluminal impedance testing is currently the most common test for quantifying gastroesophageal reflux (1). The principal indications...
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, and/or impedance planimetry. Impedance planimetry is a new technology that simultaneously measures the area across the inside of the esophagus and the pressure inside in the lumen.
