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Exp Ther Med 2021 Jun 14;21(6):604. Epub 2021 Apr 14.

5th Clinical Department, Gastroenterology and Internal Medicine Discipline, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

This prospective study aimed to determine the manometric pattern and the prevalence of esophageal dysmotility in 79 morbidly obese patients selected for laparoscopic sleeve gastrectomy. After clinical evaluation and upper gastrointestinal endoscopy, high-resolution esophageal manometry was performed. The esophageal peristalsis, lower esophageal sphincter (LES) basal pressure, and LES relaxation were evaluated. Read More

JSLS 2021 Jan-Mar;25(1)

Department of Surgery, University of Szeged, Albert Szent-Györgyi Health Center, Szeged, Hungary.

Introduction: We have analyzed the short- and long-term results of various surgical therapies for achalasia, especially changes in postoperative esophageal function.

Patients And Methods: Between January 1, 2008 and December 31, 2017, 54 patients with esophageal achalasia were treated in our institution. Patients scheduled for surgery underwent a comprehensive gastroenterological assessment pre- and post-surgery. Read More

Adv Ther 2021 Mar 27. Epub 2021 Mar 27.

Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo, SP, 04037-003, Brazil.

The Chicago Classification is the most used classification for primary esophageal motility disorders (PEMD). This classification was recently updated to the 4.0 version. Read More

Surg Endosc 2021 Mar 17. Epub 2021 Mar 17.

Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Health Sciences Center, T19-053, Stony Brook Medicine, Stony Brook, NY, 11794-8191, USA.

Introduction: Achalasia is a debilitating primary esophageal motility disorder. Heller myotomy (HM) is a first-line therapy for the treatment of achalasia patients who have failed other modalities. Other indications for HM include diverticulum, diffuse esophageal spasm, and esophageal strictures. Read More

Neurogastroenterol Motil 2021 May 5;33(5):e14119. Epub 2021 Mar 5.

Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, UK.

Distal esophageal spasm (DES) is defined as a manometric pattern of at least 20% of premature contractions in a context of normal esophago-gastric junction relaxation in a patient with dysphagia or non-cardiac chest pain. The definition of premature contraction requires the measurement of the distal latency and identification of the contractile deceleration point (CDP). The CDP can be difficult to localize, and alternative methods are proposed. Read More

Korean J Gastroenterol 2021 02;77(2):71-76

Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Patients with esophageal dysphagia need a step-by-step approach for diagnosis and treatment. Endoscopic with biopsy and barium esophagogram are the essential tests evaluating anatomical abnormality and esophageal bolus stasis. Further imaging or esophageal function tests such as high-resolution esophageal manometry, functional endoluminal imaging probe, CT or endoscopic ultrasound are required. Read More

Cureus 2021 Jan 7;13(1):e12557. Epub 2021 Jan 7.

Internal Medicine, Interfaith Medical Center, Brooklyn, USA.

Barium studies are commonly used to rule out gastrointestinal (GI) pathologies and sometimes they are associated with complications such as barium aspiration with heterogeneity in clinical features ranging from mild to severe symptoms. We present a case of large volume barium aspiration in a 73-year-old male with past medical history of dysphagia diagnosed with diffuse esophageal spasm. Barium is an inert material commonly used for GI tract study. Read More

J Neurogastroenterol Motil 2021 Apr;27(2):205-214

Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Background/aims: Several studies have reported partial recovery of peristalsis in patients with achalasia after myotomy. The aim of our study is to analyze esophageal motility patterns after peroral endoscopic myotomy (POEM) and to assess the potential predictors and clinical impact of peristaltic recovery.

Methods: We performed a retrospective analysis of prospectively collected data of consecutive patients with achalasia undergoing POEM at a tertiary center. Read More

Neurogastroenterol Motil 2021 01;33(1):e14058

Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high-resolution manometry (HRM). Read More

SA J Radiol 2020 30;24(1):1953. Epub 2020 Nov 30.

Department of Gastroenterology, Pondicherry Institute of Medical Sciences, Puducherry, India.

Vigorous achalasia is an oesophageal disorder with clinical and radiological characteristics of classic achalasia and diffuse oesophageal spasm. It is a rarely reported variant. A 60-year-old gentleman presented with complaints of difficulty in swallowing, regurgitation and chest pain for the past 10 years. Read More

Neurogastroenterol Motil 2021 01 19;33(1):e14053. Epub 2020 Dec 19.

Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Since publication of Chicago Classification version 3.0 in 2015, the clinical and research applications of high-resolution manometry (HRM) have expanded. In order to update the Chicago Classification, an International HRM Working Group consisting of 52 diverse experts worked for two years and utilized formally validated methodologies. Read More

Neurogastroenterol Motil 2021 May 4;33(5):e14043. Epub 2020 Dec 4.

Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.

Background: Several patients in gastroenterology practice present with esophageal symptoms, and in case of normal endoscopy with biopsies, high-resolution manometry (HRM) is often the next step. Our aim was to develop a European consensus on the clinical application of esophageal HRM, to offer the clinician guidance in selecting patients for HRM and using its results to optimize clinical outcome.

Methods: A Delphi consensus was initiated with 38 multidisciplinary experts from 16 European countries who conducted a literature summary and voting process on 71 statements. Read More

Rev Col Bras Cir 2020 30;47:e20202637. Epub 2020 Nov 30.

- Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo - SP - Brasil.

Objective: to evaluate esophageal dysmotility (ED) and the extent of Barrett's esophagus (BE) before and after laparoscopic Nissen fundoplication (LNF) in patients previously diagnosed with BE and ED.

Methods: twenty-two patients with BE diagnosed by upper gastrointestinal (GI) endoscopy with biopsies and ED diagnosed by conventional esophageal manometry (CEM) were submitted to a LNF, and followed up with clinical evaluations, upper GI endoscopy with biopsies and CEM, for a minimum of 12 months after the surgical procedure.

Results: : sixteen patients were male (72. Read More

Clin Endosc 2020 Nov 20;53(6):638-645. Epub 2020 Nov 20.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Peroral endoscopic myotomy (POEM) is one of the most clinically successful tunnel-based minimally invasive endoscopic treatments. The classic indications of POEM include achalasia of all types, including failed prior treatments, and expanded indications include the non-achalasia esophageal motility disorders, such as esophagogastric junction outflow obstruction, diffuse esophageal spasm, and jackhammer esophagus. For achalasia treatment, POEM has achieved a comparable surgical efficacy and a safety outcome and, therefore, has emerged as a first-line treatment. Read More

Med Clin (Barc) 2020 Oct 17. Epub 2020 Oct 17.

Servicio de Aparato Digestivo, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España.

Esophagus 2021 Apr 4;18(2):353-361. Epub 2020 Oct 4.

Division of Gastroenterology-Hepatology, Department of Medicine, Albany Medical College, Albany, NY, USA.

Background: High-resolution manometry (HRM) is a gastrointestinal motility diagnostic system that measures intraluminal pressures using closely aligned sensors. Multiple rapid swallows (MRS) are used in conjunction with HRM to assess esophageal physiology prior to anti-reflux and hiatal hernia procedures.

Methods: A retrospective, qualitative study was conducted on 90 patients who underwent HRM with MRS in a single community clinic. Read More

Am Fam Physician 2020 09;102(5):291-296

Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

Esophageal motility disorders can cause chest pain, heartburn, or dysphagia. They are diagnosed based on specific patterns seen on esophageal manometry, ranging from the complete absence of contractility in patients with achalasia to unusually forceful or disordered contractions in those with hypercontractile motility disorders. Achalasia has objective diagnostic criteria, and effective treatments are available. Read More

Ann N Y Acad Sci 2020 12 17;1482(1):95-105. Epub 2020 Aug 17.

Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona.

Gastroesophageal reflux disease (GERD) is prevalent and may be associated with both esophageal and extraesophageal syndromes, which include various pulmonary conditions. GERD may lead to pulmonary complications through the "reflux" (aspiration) or "reflex" (refluxate-triggered, vagally mediated airway spasm) mechanisms. While GERD may cause or worsen pulmonary disorders, changes in respiratory mechanics due to lung disease may also increase reflux. Read More

BMJ Case Rep 2020 Jul 31;13(7). Epub 2020 Jul 31.

Otorhinolaryngology and Head & Neck Surgery, Hospital of the Ludwig-Maximilians-University, Munich, Germany.

An 85-year-old man suffering from oropharyngeal dysphagia due to a pharyngeal pouch and cricopharyngeal spasm underwent endoscopic stapling of the pouch under general anaesthesia. During the procedure, an iatrogenic perforation of the oesophagus was noticed. After considering several options, 5 mL of Tisseel tissue glue was used to seal the perforation intraoperatively. Read More

J Clin Gastroenterol 2020 Jul 10. Epub 2020 Jul 10.

Asian Institute of Gastroenterology, Hyderabad, India.

Background And Aims: Spastic esophageal motility disorders (SEMD) are a rare group of motility disorders including type III achalasia, distal esophageal spasm (DES), and Jackhammer esophagus (JHE). Limited data suggest that per-oral endoscopic myotomy (POEM) may be effective in these disorders. In this study, we aimed to evaluate the long-term outcomes of POEM in SEMD. Read More

J Neurogastroenterol Motil 2020 07;26(3):352-361

Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background/aims: High-resolution manometry (HRM) performed without sedation is the standard procedure. However, some patients cannot tolerate transnasal placement of the manometry catheter. We aim to assess the practice of performing manometry after endoscopy with conscious sedation by evaluating its impact on esophageal motility findings. Read More

Dis Esophagus 2020 Oct;33(10)

Division of Gastroenterology and Hepatology, Mayo Clinic Arizona.

Distal esophageal spasm (DES) is a motility disorder characterized by premature contraction of the esophageal body during single swallows. It is thought to be due to impairment of esophageal inhibitory pathways, but studies to support this are limited. The normal response to multiple rapid swallows (MRS) is deglutitive inhibition of the esophageal body during the MRS sequence. Read More

Eur Heart J Suppl 2020 Jun 30;22(Suppl E):E40-E45. Epub 2020 Mar 30.

Universita' Vita-Salute e Ospedale San Raffaele, IRCCS Milano, Italy.

Myocardial infarction in the absence of obstructive coronary stenosis (MINOCA) is a syndrome with several causes, characterized by clinical evidence of myocardial infarction and coronary angiographically normal or almost normal (stenosis ≤50%). MINOCAs represent about 10% of acute coronary syndromes. The causes of MINOCA are manifold and can be classified on the basis of the mechanism in epicardial (unstable plaque not manifested by angiography, epicardial spasm and coronary dissection) or microvascular. Read More

Dig Endosc 2020 Sep 22;32(6):994. Epub 2020 Jul 22.

Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan.

Clin Case Rep 2020 May 26;8(5):927-928. Epub 2020 Feb 26.

Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan.

Diffuse esophageal spasm (DES) causes symptoms such as dysphagia. However, DES is sometimes difficult to diagnose. DES can be diagnosed based on a characteristic image through esophageal radiography. Read More

Curr Opin Gastroenterol 2020 07;36(4):344-350

Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA.

Purpose Of Review: Chronic opioid use is common and can cause opioid-induced esophageal dysfunction (OIED). We will discuss the pathophysiology, diagnosis, and management of OIED.

Recent Findings: OIED is diagnosed based on symptoms, opioid use, and manometric evidence of distal esophageal spasm, esophagogastric junction outflow obstruction, achalasia type III, or jackhammer esophagus. Read More

Indian J Gastroenterol 2020 04 9;39(2):165-170. Epub 2020 May 9.

Department of Gastroenterology, Arihant Hospital and Research Centre, 283-A Gumasta Nagar, Indore, 452 009, India.

Background: A proportion of patients with gastroesophageal reflux disease (GERD) do not respond to proton pump inhibitor (PPI) therapy.

Aim Of The Study: To determine the findings on high-resolution esophageal manometry (HREM) and 24-h pH recording in patients with typical GERD symptoms, refractory to PPI treatment.

Methods: Retrospective analysis of prospectively maintained database of patients referred for HREM and 24-h pH recording was done. Read More

Endoscopy 2020 06 6;52(6):498-515. Epub 2020 May 6.

Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

ESGE recommends the use of a graded pneumatic dilation protocol in achalasia, starting with a 30-mm dilation and followed by a 35-mm dilation at a planned interval of 2 - 4 weeks, with a subsequent 40-mm dilation when there is insufficient relief, over both a single balloon dilation procedure or the use of a larger balloon from the outset.Strong recommendation, high quality of evidence, level of agreement 100 %.ESGE recommends being cautious in treating spastic motility disorders other than achalasia with peroral endoscopic myotomy (POEM). Read More

Cureus 2020 Mar 6;12(3):e7192. Epub 2020 Mar 6.

Family Medicine, Geisinger Health System, Lewistown, USA.

Diffuse esophageal spasm, also known as distal esophageal spasm (DES), is a rare motility disorder among the population with symptomatic motility disorders. This disorder is most commonly reported in females, with a median age of 60 years. Multiple therapeutic options have been developed for the treatment of DES. Read More