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Dig Endosc 2020 Jun 2. Epub 2020 Jun 2.

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

An 80-year-old man presented with a 1-year history of dysphagia and 2 to 3-months history of chest pain. He was suspected to have ischemic heart disease and was treated with nitroglycerin at another hospital which did not relieve of his symptoms. Recently, he started to have reflux of gastric juice while sleeping, hence, prompting him to seek consult in our hospital. Read More

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 May 13. Epub 2020 May 13.

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 May 9. 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 Jun 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

World J Clin Cases 2020 Mar;8(6):1026-1032

Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA 30303, United States.

Distal esophageal spasm (DES) is a rare major motility disorder in the Chicago classification of esophageal motility disorders (CC). DES is diagnosed by finding of ≥ 20% premature contractions, with normal lower esophageal sphincter (LES) relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0. Read More

Clin Gastroenterol Hepatol 2020 Mar 20. Epub 2020 Mar 20.

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

Background & Aims: A normal esophageal response to distension on functional luminal imaging probe (FLIP) panometry during endoscopy might indicate normal esophageal motor function. We aimed to investigate the correlation of normal FLIP panometry findings with esophageal high-resolution manometry (HRM) and outcomes of discrepant patients.

Methods: We performed a retrospective study using data from a registry of patients who completed FLIP during sedated endoscopy. Read More

Handb Exp Pharmacol 2020 Feb 19. Epub 2020 Feb 19.

Department of Surgery, "San Giovanni di Dio" Hospital, Crotone, Italy.

Botulinum toxin (BT), one of the most powerful inhibitors that prevents the release of acetylcholine from nerve endings, represents an alternative therapeutic approach for "spastic" disorders of the gastrointestinal tract such as achalasia, gastroparesis, sphincter of Oddi dysfunction, chronic anal fissures, and pelvic floor dyssynergia.BT has proven to be safe and this allows it to be a valid alternative in patients at high risk of invasive procedures but long-term efficacy in many disorders has not been observed, primarily due to its relatively short duration of action. Administration of BT has a low rate of adverse reactions and complications. Read More

Head Neck 2020 Apr 7;42(4):708-718. Epub 2020 Feb 7.

Department of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah.

Background: Limited data exist regarding which head and head and neck cancer (HNC) survivors will suffer from long-term dysphagia.

Methods: From a population-based cohort of 1901 Utah residents with HNC and ≥3 years follow-up, we determined hazard ratio for dysphagia, aspiration pneumonia, or gastrostomy associated with various risk factors. We tested prediction models with combinations of factors and then assessed discrimination of our final model. Read More

Curr Med Imaging Rev 2020 ;16(1):65-69

Department of Radiology, Medical Faculty, Istanbul University Cerrahpasa, Kocamustafapasa, Istanbul, Turkey.

Background: Esophageal motility studies are performed in patients who have dysphagia that is not explained by stenosis. Diagnosis can be challenging and requires expertise in the interpretation of tests and symptoms.

Aims: Our aim is to investigate the diagnostic value of videofluoroscopic swallowing study (VFSS) in combination with esophageal manometry. Read More

Med J Malaysia 2019 12;74(6):540-542

Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Medicine, Gastroenterology Unit, Kuala Lumpur, Malaysia.

Distal oesophageal spasm is a rare condition that affects the motility of the oesophagus. It can be diagnosed by highresolution oesophageal manometry and the diagnosis is supported by other modalities such as barium swallow and esophagogastroduodenoscopy examinations. Treatment options include pharmacological therapy, endoscopy and surgical interventions. Read More

Dis Esophagus 2020 Mar;33(3)

Stanford Esophageal Multidimensional Program in Innovation and Research Excellence (SEMPIRE), Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94305, USA.

Although High resolution esophageal manometry (HRM) is the gold standard to assess esophageal motility, little is known about the stability of the manometric diagnosis over time and its implications for management. To assess the stability and usefulness of repeat HRM in patients presenting with esophageal symptoms over time we performed this retrospective study of patients with esophageal symptoms. Medical records, questionnaires, and HRM tracing were independently reviewed using the Chicago classification. Read More

Eur J Case Rep Intern Med 2019 11;6(12):001369. Epub 2019 Dec 11.

Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Switzerland.

Introduction: "Esophageal spasm" is a generic term widely used to attribute unexplained non-cardiac chest pain and/or dysphagia to an esophageal motility disorder.

Patient And Methods: The authors present the case of an 86-year-old male patient with complete dysphagia after an elective electrical cardioversion for atrial fibrillation. An upper endoscopy performed shortly after the onset of the clinical picture documented disordered esophageal contractions. Read More

Frontline Gastroenterol 2020 Jan 26;11(1):75-77. Epub 2019 Jun 26.

Paediatric Gastroenterology, Evelina London Children's Hospital, London, UK.

We report a case of a school-age child with symptomatic distal oesophageal spasm (DES), clinical dysphagia and typical feature in high-resolution oesophageal manometry secondary to eosinophilic oesophagitis (EoE). His symptoms resolved with normalisation of oesophageal manometry after standard treatment of EoE. DES is mainly an adult disorder and rarely affect children; to the best of our knowledge, this is the first reported case in a child that document full recovery after treating the underlying EoE. Read More

Z Gastroenterol 2019 Dec 11;57(12):1481-1486. Epub 2019 Dec 11.

Department of Gastroenterology, Ninghe Hospital of Tianjin, Tianjin, China.

Introduction:  Distal esophageal spasm (DES), a relatively rare condition, is characterized by simultaneous contractions of the distal esophagus and manifested by dysphagia and chest pain. Several treatment options are recommended, such as pharmacological therapy, endoscopic interventions, and surgical myotomy. Recently, per-oral endoscopic myotomy (POEM) has been adopted as an effective and less-invasive treatment due to its excellent short-term clinical outcomes. Read More

J Cardiol Cases 2019 Nov 23;20(5):183-186. Epub 2019 Aug 23.

Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan.

Fluorouracil (5-FU), a commonly used anticancer agent, has potent cardiotoxicity that is mediated by vascular endothelial injury and vasospasm. Here, we report a patient demonstrating atrial fibrillation (AF), which was most likely induced by vasospasm mediated by 5-FU. A 69-year-old man presented with dysphagia and was diagnosed with advanced esophageal cancer. Read More

Esophagus 2020 Jan 12;17(1):11-18. Epub 2019 Oct 12.

Department of Gastroenterology, Lanzhou University Second Hospital, NO. 82 Cuiying Men, Cheng Guan District, Lanzhou, 730030, Gansu Province, China.

Background: Esophageal motility disorders which include achalasia, esophagogastric junction outflow obstruction (EGJ outflow obstruction), jackhammer esophagus (JE), distal esophageal spasm (DES), etc. are rare disease of unknown causes. The diagnosis is based on endoscopy, barium meal, and high-resolution manometry (HRM). Read More

Expert Rev Gastroenterol Hepatol 2019 Oct 9;13(10):933-942. Epub 2019 Oct 9.

Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

: Peroral endoscopic myotomy (POEM) has been established as an alternative endoscopic method for the treatment of achalasia, and several studies have confirmed its relatively long-term efficacy. Although most of the POEM procedures can be smoothly completed, technical difficulties do arise during the treatment of some patients, which may lead to prolonged procedure duration, increased procedure-related complications, or even aborted POEM.: In the present review, we provide a comprehensive review of difficult POEM, focusing on its definition, risk factors, and intraoperative management strategies. Read More

Am J Gastroenterol 2019 09;114(9):1464-1469

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

Objective: Data regarding opioid effects on esophageal function are limited. We previously demonstrated an association between chronic opioid use and esophageal motor dysfunction characterized by esophagogastric junction outflow obstruction, distal esophageal spasm, achalasia type III, and possibly Jackhammer esophagus. Our aim was to characterize the influence of different opioids and doses on esophageal dysfunction. Read More

Clin Res Hepatol Gastroenterol 2020 Feb 10;44(1):82-89. Epub 2019 May 10.

Department of gastroenterology, Cochin hospital, assistance publique - Hôpitaux de Paris, Paris Descartes university, 27, rue du Faubourg St Jacques 75014, Paris, France.

Introduction: Mid-esophageal and epiphrenic diverticula (MED) can be associated with esophageal motility disorders. Per-oral endoscopic myotomy (POEM) is an established treatment for esophageal motility disorders that has also been introduced for the treatment of MED.

Methods: Data were prospectively collected from patients with MED treated with POEM at our institution. Read More

Surg Endosc 2020 02 9;34(2):707-718. Epub 2019 May 9.

Division of Gastroenterology & Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA.

Background: POEM has been successfully performed in patients with spastic esophageal disorders (SED), such as diffuse esophageal spasm, jackhammer esophagus, and type 3 achalasia. We performed a systematic review and meta-analysis to evaluate its efficacy in these patients and if total average myotomy length and prior medical or endoscopic treatments affected clinical success.

Methods: PubMed, EMBASE, Google-Scholar, Scopus, and Cochrane Review were searched for studies on POEM in SED from 2008 to September 2018. Read More

World J Gastrointest Endosc 2019 Apr;11(4):292-297

Department of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.

Background: Esophageal varices are a result of progressive liver disease and portal hypertension. Treatment can be performed with band ligation versus non-selective beta blockers depending on the size of varices, ability to tolerate medications and history of variceal bleeding. Band ligation is an effective intervention with rare but serious complications including bleeding, ulcers and rarely obstruction. Read More

Neurogastroenterol Motil 2019 05;31(5):e13594

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

In this issue of the journal, Mion and coworkers describe 23 patients with dysphagia and/or thoracic pain and hypercontractile esophageal motility disorders who were either treated with botulinum toxin 100 U or underwent a sham procedure. The surprising outcome of the study was that both active botulinum toxin treatment and sham treatment resulted in a significant reduction in symptoms and manometric abnormalities after 3 months, with no difference between the two arms. One can interpret the lack of effect of botulinum toxin over placebo as indicative of the benign natural history of hypercontractile esophageal motility disorders or be convinced that many patients with hypercontractility on manometry actually have functional symptoms not related to the manometric findings, and thus, treatment of hypercontractility is not more effective than placebo. Read More

Heart Vessels 2019 Oct 16;34(10):1631-1638. Epub 2019 Apr 16.

Department of Cardiovascular Medicine, JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057, Japan.

It is well known that patients with gastroesophageal reflux disease (GERD) experience GERD-related chest pain, but little is known about the relationship between GERD and coronary artery disease (CAD). We evaluated medical history of GERD in patients with suspected CAD and its association with types of CAD. We enrolled 236 patients who underwent coronary angiography (CAG). Read More

J Gastroenterol 2019 Nov 1;54(11):950-962. Epub 2019 Apr 1.

Division of Gastroenterology and Hepatology, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Japan.

Background: Esophageal motility abnormalities (EMAs) and interstitial lung diseases (ILDs) are often seen in patients with systemic sclerosis (SSc). Gastroesophageal reflux disease (GERD) could be associated with ILDs, but it is not fully understood if ILDs are caused by GERD or SSc itself.

Methods: A total of 109 patients with SSc who underwent high-resolution manometry were enrolled. Read More

Cir Esp 2019 Nov 25;97(9):533. Epub 2019 Feb 25.

Department of Medicine and Surgery, University of North Carolina, Chapel Hill, North Carolina, EE. UU.

Dig Dis Sci 2019 08 15;64(8):2214-2218. Epub 2019 Feb 15.

Department of Medicine, Division of Gastroenterology and Hepatology, Medical University of South Carolina, 30 Courtenay Drive, Suite 249, MSC 702, Charleston, SC, 29425-2900, USA.

Background: Due to its smooth muscle relaxing properties, peppermint oil (PO) may relieve dysphagia and chest pain due to esophageal motility disorders.

Aim: To explore the impact of PO on dysphagia and/or chest pain in patients referred for motility testing.

Methods: Patients initiated on PO for dysphagia and/or chest pain from 2013 to 2016 were identified. Read More

Turk J Med Sci 2019 Feb 11;49(1):258-264. Epub 2019 Feb 11.

Background/aim: We aimed to compare the effectivity of percutaneous disc coagulation therapy (PDCT) and navigable ablation decompression treatment (L-DISQ) in patients who were diagnosed with cervical disc herniation.

Materials And Methods: Visual analog scale (VAS) and Neck Pain Index (NPI) scores were recorded initially and at the 1st, 3rd, 6th, and 12th months after the procedures. Patient Satisfaction Scale (PSS) scores were recorded 12 months after the procedures

Results: Mean VAS scores were 7. Read More

Ter Arkh 2018 May;90(5):93-100

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.

Aim: To present application of Chicago classification criteria of esophageal motility disorders defined in high resolution manometry in clinical practice.

Materials And Methods: High-resolution manometry is the most exact hi-tech diagnostic method for esophageal motor function disorders according to Chicago classification v3.0. Read More

Acta Med Okayama 2018 Dec;72(6):595-600

Department of Gastroenterology and Hepatology, Okayama University Hospital, Okayama 700-8558,

The indications for peroral endoscopic myotomy (POEM) have been expanded to include diffuse esophageal spasm (DES). A 67-year-old Japanese man presented with a 4-year history of dysphagia. Endoscopy and upper gastrography revealed abnormal peristaltic movements involving interruption of normal peristalsis, and a diverticulum located at the 2 o'clock esophageal position. Read More

J Surg Res 2018 12 8;232:587-594. Epub 2018 Aug 8.

Department of Surgery, University of Virginia, Charlottesville, Virginia.

Background: In North America, the prevalence of gastroesophageal reflux disorder ranges from 18.1% to 27.8%. Read More

Rev Esp Geriatr Gerontol 2019 Mar - Apr;54(2):120-121. Epub 2018 Nov 1.

Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España.

Z Gastroenterol 2018 Nov 8;56(11):1337-1342. Epub 2018 Oct 8.

Department of Internal Medicine and Gastroenterology, Elisabeth-Krankenhaus Essen, Essen, Germany.

Background: Noncardiac chest pain (NCCP) is recurrent angina pectoris-like pain without evidence of coronary heart disease in conventional diagnostic evaluation. In gastroenterology, managing of patients with NCCP is ambiguous to detect gastroesophageal reflux and hypercontractile esophageal motility disorders. Recently, peroral endoscopic myotomy (POEM) was established as treatment option in achalasia. Read More

Endocr Metab Immune Disord Drug Targets 2019 ;19(2):230-231

Department of Internal Medicine, University of Missouri, Columbia, MO, United States.

Background: Dysphagia affects one in twenty-five adults yearly in the United States.

Objective: While dysphagia may be common, the prevalence of dysphagia may be underestimated primarily due to under-reporting. Dysphagia may be caused by intraluminal, intrinsic, extrinsic, or motility disorders. Read More

J Gastrointest Surg 2019 01 4;23(1):36-42. Epub 2018 Oct 4.

Center for Advanced Surgical Technology, University of Nebraska Medical Center, 986246 Nebraska Medical Center, Omaha, NE, 68198-6246, USA.

Background: Gastroesophageal reflux disease (GERD) and esophageal dysmotility are often disqualifying criteria for fundoplication due to dysphagia complications. A tailored partial fundoplication may improve GERD in patients with severe esophageal motility disorders. We evaluate this approach on GERD improvement in non-achalasia esophageal dysmotility patients. Read More

Curr Opin Otolaryngol Head Neck Surg 2018 Dec;26(6):375-381

Department of Otolaryngology.

Purpose Of Review: The article reviews the effects of cervical osteophytosis and spine posture on swallowing, and how they can cause dysphagia.

Recent Findings: Cerivical osteophytosis which is a bony overgrowth of the cervical spines, it affects the swallowing through different mechanisms, including direct mechanical compression of the pharynx and esophagus, disturbances of normal epiglottic tilt over the inlet of the larynx by the osteophytes at C3-C4 level, inflammatory reactions in the tissues around the esophagus and cricopharyngeal spasm. Also, cervical spine posture in normal individuals could affect the swallowing mechanism by disturbance of the sphincteric action of the larynx and upper esophageal sphincter. Read More

Surg Endosc 2019 05 19;33(5):1632-1639. Epub 2018 Sep 19.

Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 3805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.

Background: Optimal treatment for symptomatic patients with non-achalasia motility disorders (NAD) such as diffuse esophageal spasm, esophagogastric junction outlet obstruction, and hypercontractile disorder is not well established. POEM has been offered to these patients since it is a less invasive and less morbid procedure but long-term outcomes remain undetermined. The aim of this study was to assess long-term outcomes of POEM for patients with NAD. Read More

Dig Dis Sci 2018 12;63(12):3164-3166

Division of Gastroenterology, Department of Medicine, Kansas University Medical Center, Kansas City, KS, USA.

Case Rep Gastrointest Med 2018 7;2018:9720243. Epub 2018 Aug 7.

Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Veterans Affairs Maryland Health Care System, Baltimore, MD 21201, USA.

Background: High-resolution impedance manometry (HRiM) is the test of choice to diagnose esophageal motility disorders and is particularly useful for identifying achalasia subtypes, which often guide therapy. HRiM is typically performed without sedation in the office setting. However, a substantial number of patients fail this approach. Read More

Gastroenterol Rep (Oxf) 2018 Aug 2;6(3):177-183. Epub 2018 Jun 2.

Department of Gastroenterology and Hepatology, Digestive Diseases and Surgical Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA.

Background: High-resolution esophageal manometry (HREM) is the diagnostic test of choice for evaluation of non-obstructive dysphagia. Studies regarding the predictors of esophageal dysmotility are limited. Therefore, our aim was to study the prevalence of and factors associated with esophageal motility disorders in patients with non-obstructive dysphagia. Read More

Am J Case Rep 2018 Aug 23;19:998-1003. Epub 2018 Aug 23.

Department of Surgery, Universiti Kebagsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia.

BACKGROUND The esophagus can be affected by a variety of disorders that may be primary or secondary to another pathologic process, but the resulting symptoms are usually not pathognomonic for a specific problem, making diagnosis and further management somewhat challenging. High resolution impedance manometry (HRiM) has established itself as a valuable tool in evaluating esophageal motility disorder. HRiM is superior in comparison with conventional water perfused manometric recordings in delineating and tracking the movement of functionally defined contractile elements of the esophagus and its sphincters, and in distinguishing the luminal pressurization of spastic esophageal contraction from a trapped bolus. Read More

Endosc Int Open 2018 Aug 10;6(8):E1031-E1036. Epub 2018 Aug 10.

Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States.

Background And Study Aims : The efficacy of per oral endoscopic myotomy (POEM) in non-achalasia esophageal motility disorders such as esophagogastric junction outflow obstruction (EGJOO), diffuse esophageal spasm (DES), and jackhammer esophagus (JE) has not been well demonstrated. The aim of this international multicenter study was to assess clinical outcomes of POEM in patients with non-achalasia disorders, namely DES, JE, and EGJOO, in a large cohort of patients.

Patients And Methods : This was a retrospective study at 11 centers. Read More

Curr Gastroenterol Rep 2018 Aug 6;20(9):42. Epub 2018 Aug 6.

Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Purpose Of Review: This review addresses the similarities and differences between the spastic esophageal disorders, including jackhammer esophagus, distal esophageal spasm (DES), and type III (spastic) achalasia. The pathophysiology, diagnosis, and treatment of each separate disorder are discussed herein, with an emphasis on overlapping and discordant features.

Recent Findings: The Chicago Classification is a hierarchical organizational scheme for esophageal motility disorders, currently in its third iteration, with direct impact on the definitions of these three disorders. Read More

BMJ Open Gastroenterol 2018 25;5(1):e000210. Epub 2018 Jul 25.

Stanford Esophageal Multi-disciplinary Program in Innovative Research Excellence (SEMPIRE), Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA.

Background: The Chicago Classification (CC) defines oesophagogastric junction outflow obstruction (EGJOO) as the presence of an elevated integrated residual pressure (IRP) together with preserved oesophageal body peristalsis but its clinical significance is evolving.

Aims: To describe the clinical and manometric characteristics in patients with EGJOO and propose a new classification.

Methods: In this retrospective cohort study, patients with functional oesophageal symptoms underwent clinical and endoscopic assessment and oesophageal high-resolution manometry (HRM). Read More

Acta Gastroenterol Belg 2018 Apr-Jun;81(2):295-304

Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Diagnostic criteria for esophageal motor disorders have recently been updated with the advent of high-resolution manometry that gives a precise mapping of peristaltic abnormalities and an indirect view of bolus transit problems. Achalasia, the best-defined motor disorder, is now divided in subsets of manometric phenotypes that predict outcome of treatment and guide our therapeutic approach. Pharmacological therapy using smooth muscle relaxants for spastic esophageal disorders remains poorly effective and used only as a bridge to more effective therapies : endoscopic balloon dilation and surgical myotomy are both effective therapies in achalasia, myotomy being considered as the preferred approach in children because it is aimed to be definitive, while dilations usually have to be repeated. Read More

Visc Med 2018 Apr 12;34(2):92-96. Epub 2018 Apr 12.

Department of Gastroenterology, Hepatology, Infectiology, Neurogastroenterology, Hematology, Oncology, and Palliative Medicine, HELIOS-Clinic Krefeld, Krefeld, Germany.

Background: Non-cardiac chest pain (NCCP) is recurrent angina pectoris-like pain without evidence of coronary heart disease in conventional diagnostic evaluation. The prevalence of NCCP is up to 70% and may be detected (in this order) at all levels of the medical health care system (general practitioner, emergency department, chest pain unit, coronary care). Reduction of quality of life due to NCCP is comparable, and partially even higher, to that caused by cardiac chest pain. Read More

Digestion 2018 5;98(3):153-160. Epub 2018 Jun 5.

Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.

Background/aims: Endoscopic submucosal dissection (ESD) for superficial esophageal cancer is sometimes extensive, and in our experience, patients not infrequently present with dysphagia after ESD even in the absence of esophageal stricture. The aim of this study was to evaluate esophageal motility using high-resolution manometry (HRM) in patients with and without dysphagia after extensive circumferential ESD.

Methods: HRM was performed in a total of 52 patients who had undergone ESD for superficial esophageal cancer and a mucosal defect after ESD exceeded more than two-thirds of the esophageal circumference. Read More