Two Distinct Types of Hypercontractile Esophagus: Classic and Spastic Jackhammer.
- Author:
Yun Soo HONG
1
;
Yang Won MIN
;
Poong Lyul RHEE
Author Information
- Publication Type:Original Article
- Keywords: Deglutition disorders; Dysphagia; Esophageal motility disorders
- MeSH: Classification; Cyclic Nucleotide Phosphodiesterases, Type 5; Deglutition Disorders; Esophageal Motility Disorders; Esophagus*; Humans; Muscle Spasticity*; Muscle, Smooth; Scopolamine Hydrobromide
- From:Gut and Liver 2016;10(5):859-863
- CountryRepublic of Korea
- Language:English
- Abstract: Hypercontractile esophagus (nicknamed jackhammer esophagus) is a recently defined disease within the esophageal motility disorders classification. Responses to treatments for jackhammer esophagus have been inconsistent in previous trials, possibly due to its heterogeneous manifestation. Thus, we reviewed 10 patients diagnosed with jackhammer esophagus and compared their clinical and manometric features at baseline. Additionally, manometric and symptomatic responses after treatment with known smooth muscle relaxants, including anticholinergic drugs (cimetropium bromide and scopolamine butylbromide) and a phosphodiesterase-5 inhibitor (sildenafil) were compared. We observed two distinct subgroups in the findings: one with hypercontractility and normal distal latencies (“classic jackhammer esophagus,” n=7) and the other with hypercontractility and short distal latencies (“spastic jackhammer esophagus,” n=3). The two types also differed in their responses to medications in that symptoms improved upon treatment with an anticholinergic agent in classic jackhammer esophagus patients, while spastic jackhammer esophagus was unresponsive to both the anticholinergic drugs and the phosphodiesterase-5 inhibitor. In conclusion, hypercontractile esophagus may be a heterogeneous disease with different underlying pathophysiologies. We introduced two novel terms, “classic jackhammer esophagus” and “spastic jackhammer esophagus,” to distinguish the two types.
