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An EMS is typically done to evaluate suspected disorders of motility or peristalsis of the esophagus. These include achalasia, diffuse esophageal spasm, nutcracker esophagus and hypertensive lower esophageal sphincter. These disorders typically present with dysphagia, or difficulty swallowing, usually to both solids and liquids even initially.
Diffuse esophageal spasm; Nutcracker esophagus; Hypertensive lower esophageal sphincter; An esophageal motility disorder can also be secondary to other diseases. [1] For example, it may be a result of CREST syndrome, referring to the five main features: calcinosis, Raynaud syndrome, esophageal dysmotility, sclerodactyly and telangiectasia. [2]
Autoimmune gastrointestinal dysmotility (AGID) is an autoimmune disease autonomic neuropathy affecting the gastrointestinal organs and digestive system of the body. Dysmotility is when the strength or coordination of the esophagus , stomach or intestines muscles do not work as they should.
Esophageal cancer also presents with progressive mechanical dysphagia. Patients usually come with rapidly progressive dysphagia first with solids then with liquids, weight loss (> 10 kg), and anorexia (loss of appetite). Esophageal cancer usually affects the elderly. Esophageal cancers can be either squamous cell carcinoma or adenocarcinoma.
Esophageal spasm is a disorder of motility of the esophagus. [2] There are two types of esophageal spasm: [2] Diffuse or distal esophageal spasm (DES), where there is uncoordinated esophageal contractions; Nutcracker esophagus (NE) also known as hypertensive peristalsis, where the contractions are coordinated but with an excessive amplitude.
Functional Lumen Imaging Probe (FLIP) is a test used to evaluate the function of the esophagus, by measuring the dimensions of the esophageal lumen using impedance planimetry. Typically performed with sedation during upper endoscopy , FLIP is used to evaluate for esophageal motility disorders , such as achalasia , diffuse esophageal spasm , etc ...
Diffuse esophageal spasm (DES), also known as distal esophageal spasm, is a condition characterized by uncoordinated contractions of the esophagus, which may cause difficulty swallowing or regurgitation. In some cases, it may cause symptoms such as chest pain, similar to heart disease. In many cases, the cause of DES remains unknown.
The diagnosis of nutcracker esophagus is typically made with an esophageal motility study, which shows characteristic features of the disorder. Esophageal motility studies involve pressure measurements of the esophagus after a patient takes a wet (fluid-containing) or dry (solid-containing) swallow. Measurements are usually taken at various ...