| A unique esophageal motor pattern that involves longitudinal muscles is responsible for emptying in achalasia esophagus. | |
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MedLine Citation:
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PMID: 20381493 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: Achalasia esophagus is characterized by loss of peristalsis and incomplete esophagogastric junction (EGJ) relaxation. We studied mechanisms of esophageal emptying in patients with achalasia using simultaneous high-resolution manometry, multiple intraluminal impedance, and high-frequency intraluminal ultrasonography image recordings. METHODS: Achalasia was categorized into 3 subtypes, based on the esophageal response to swallows: types 1 and 2 were defined by simultaneous pressure waves of <30 mm Hg and >30 mm Hg, respectively, and type 3 was defined by spastic simultaneous esophageal contractions. RESULTS: Based on high-resolution manometry, the predominant achalasia pattern of type 2 was characterized by a unique motor pattern that consisted of upper esophageal sphincter contraction, simultaneous esophageal pressure (pan-esophageal pressurization), and EGJ contraction following swallows. High-frequency intraluminal ultrasonography identified longitudinal muscle contraction of the distal esophagus as the cause of pan-esophageal pressurization in type 2 achalasia. Multiple intraluminal impedance revealed that esophageal emptying occurred intermittently (36% swallows) during periods of pan-esophageal pressurization. Patients with achalasia of types 1 and 3 had no emptying or relatively normal emptying during most swallows, respectively. CONCLUSIONS: In achalasia, esophageal emptying results from swallow-induced longitudinal muscle contraction of the distal esophagus, which increases esophageal pressure and allows flow across the nonrelaxed EGJ. |
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Authors:
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Su Jin Hong; Valmik Bhargava; Yanfen Jiang; Debbie Denboer; Ravinder K Mittal |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-04-08 |
Journal Detail:
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Title: Gastroenterology Volume: 139 ISSN: 1528-0012 ISO Abbreviation: Gastroenterology Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-12 Completed Date: 2010-08-04 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 0374630 Medline TA: Gastroenterology Country: United States |
Other Details:
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Languages: eng Pagination: 102-11 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, South Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Electric Impedance Esophageal Achalasia / physiopathology* Esophageal Sphincter, Upper / physiopathology Esophagogastric Junction / physiopathology Esophagus / physiopathology*, ultrasonography Humans Manometry Muscle Contraction* Retrospective Studies |
| Grant Support | |
ID/Acronym/Agency:
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R01 DK060733-02/DK/NIDDK NIH HHS; R01-DK060733/DK/NIDDK NIH HHS |
| Comments/Corrections | |
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