Oesophageal motility disorders Flashcards Preview

Liver + GI > Oesophageal motility disorders > Flashcards

Flashcards in Oesophageal motility disorders Deck (8)
Loading flashcards...

What is achalasia?

oesophageal aperistalsis and failure of the LOS impair oesophageal emptying


pathology achalasia

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


clinical features of achalasia

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


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?


management for achalasia

no cure
endoscopic balloon dilatation
surgical division of the LOS

medical to relax LOS e.g. oral nitrates


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


symptoms of scleroderma?

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


treatment for scleroderma?

same as for reflux and stricture formation