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Flashcards in Oesophageal motility disorders Deck (8)
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1

What is achalasia?

oesophageal aperistalsis and failure of the LOS impair oesophageal emptying

2

pathology achalasia

decrease in ganglionic cells in nerve plexus of the oesophageal wall and degeneration in the vagus nerve

3

clinical features of achalasia

long Hx of dysphagia for both liquids and solids, may be associated with regurgitation
retrosternal chest pain

4

investigations for achalasia

barium swallow: dilated oesophagus with gradually tapering lower end. absence of peristalsis

oesophageal manometry: aperistalsis + failure of LOS on swallowing

OGD: to exclude cancer

CXR: dilated oesophagus? fluid level behind heart?

5

management for achalasia

no cure
endoscopic balloon dilatation
surgical division of the LOS

medical to relax LOS e.g. oral nitrates

6

how does systemic sclerosis/sclerodema --> gastro-oesophageal reflux?

systemic sclerosis was formerly CREST syndrome

smooth muscle layer is replaced by fibrous tissue and LOS pressure is reduced

7

symptoms of scleroderma?

result of reflux (leading to oesophagitis and strictures)
oesophageal hypomobility

8

treatment for scleroderma?

same as for reflux and stricture formation