No abstract available.
Endoscopy* ; Esophageal Motility Disorders*

No abstract available.
Esophageal Motility Disorders*

No abstract available.
Esophageal Motility Disorders* ; Gastroesophageal Reflux*

For several decades esophageal manometry has been the test of choice to evaluate disorders of esophageal motor function. The recent introduction of high-resolution manometry for the study of esophageal motor function simplified performance of esophageal manometry, and revealed previously unidentified patterns of normal and abnormal esophageal motor function. Presentation of pressure data as color contour plots or esophageal pressure topography led to the development of new tools for analyzing and classifying esophageal motor patterns. The current standard and still developing approach to do this is the Chicago classification. While this methodical approach is improving our diagnosis of esophageal motor disorders, it currently does not address all motor abnormalities. We will explore the Chicago classification and disorders that it does not address.
Chicago ; Esophageal Motility Disorders ; Esophagus ; Manometry

Esophageal bezoars are rare, but are recognized as a distinct clinical entity. They are known to occur in patients with esophageal structural and functional abnormalities, but only a few cases of the development of esophageal bezoars in patients with esophageal motility disorders have only been described. We report a rare case of an esophageal bezoar that developed in a patient with achalasia, and review the literature concerning esophageal bezoars associated with esophageal motility disorders.
Bezoars ; Esophageal Achalasia ; Esophageal Motility Disorders ; Esophagus ; Humans

BACKGROUND/AIMS: Achalasia is a rare esophageal motility disorder. Recently, a novel endoscopic technique, peroral endoscopic myotomy (POEM), was introduced as an alternative treatment for achalasia. We report the results and short term outcomes of POEM for patients with achalasia. METHODS: POEM was performed in 13 patients with achalasia. The procedure consisted of creating a submucosal tunnel followed by endoscopic myotomy of circular muscle bundles. The mucosal entry was closed by conventional hemostatic clips. A validated clinical symptom score (Eckardt score) and high resolution manometry were used to evaluate the outcomes. RESULTS: Both the clinical score of achalasia, as well as the resting lower esophageal sphincter (LES) pressure, were significantly reduced after POEM. Mean posttreatment Eckardt score was 0.4+/-0.7, compared to 6.4+/-1.9 prior to the treatment (p=0.001). The mean pretreatment and posttreatment LES pressure was 30.3 and 15.3 mm Hg, respectively (p=0.007). Following POEM, symptomatic relief from dysphagia without reflux symptoms was observed in all patients (13/13). No serious complications related to POEM were encountered. CONCLUSIONS: Based upon our initial experience, the authors believe that POEM is a feasible, safe, and effective treatment and may possibly substitute established treatments of refractory achalasia.
Deglutition Disorders ; Esophageal Achalasia ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower ; Humans ; Manometry ; Muscles

Esophageal high-resolution manometry (HRM) is replacing conventional manometry in the clinical evaluation of patients with esophageal symptoms, especially dysphagia. The introduction of HRM gave rise to new objective metrics and recognizable patterns of esophageal motor function, requiring a new classification scheme: the Chicago classification. HRM measurements are more detailed and more easily performed compared to conventional manometry. The visual presentation of acquired data improved the analysis and interpretation of esophageal motor function. This led to a more sensitive, accurate, and objective analysis of esophageal motility. In this review we discuss how HRM changed the way we define and categorize esophageal motility disorders. Moreover, we discuss the clinical applications of HRM for each esophageal motility disorder separately.
Classification ; Deglutition Disorders ; Diagnosis* ; Esophageal Achalasia ; Esophageal Motility Disorders* ; Esophageal Spasm, Diffuse ; Humans ; Manometry*

No abstract available.
Aniridia ; Cerebellar Ataxia ; Esophageal Motility Disorders* ; Intellectual Disability

With the development of optics and mechanics, endoscopic technologies are not only used as a simple diagnostic method, but also applied in therapy. Since the beginning of the 21st century, minimally invasive medicine has become the development trend. Many novel technologies have appeared, such as endoscopic mucosal resection, endoscopic submucosal dissection, and peroral endoscopic myotomy. Esophageal motility disorders are common diseases in clinic, which seriously affect the quality of life. Although esophageal manometry is the golden diagnostic standard, endoscopy also plays an important role in diagnosis. There are many therapeutic methods in achalasia and gastroesophageal reflux diseases with good efficacy, while the therapy in other esophageal motility disorders remains in dispute. According to the domestic and foreign research progressions, we introduce the role of endoscopy in the diagnosis and management of esophageal motility disorders.
Endoscopy, Digestive System ; Esophageal Motility Disorders ; diagnosis ; surgery ; Humans

Achalasia is an esophageal motility disorder characterized by incomplete relaxation of the lower esophageal sphincter (LES) and aperistalsis of the esophageal body. Treatment of achalasia is aimed at decreasing the resting pressure in the LES. Peroral endoscopic myotomy (POEM), derived from natural orifice transluminal endoscopic surgery (NOTES) and advances in endoscopic submucosal dissection (ESD), presents a novel, minimally invasive, and curative endoscopic treatment for achalasia. POEM involves an esophageal mucosal incision followed by creation of a submucosal tunnel crossing the esophagogastric junction and myotomy before closure of the mucosal incision. Although the procedure is technically demanding and requires a certain degree of skill and competency, treatment success is high (90%) with low complication rates. Since the first described POEM in humans in 2010, it has been used increasingly at centers worldwide. This article reviews available published clinical studies demonstrating POEM efficacy and safety in order to present a proposal on how to establish a dedicated POEM program and reach base proficiency for the procedure.
Esophageal Achalasia ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower ; Esophagogastric Junction ; Humans ; Natural Orifice Endoscopic Surgery ; Relaxation