Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Apart from gastroesophageal reflux disease, achalasia, non-cardiac chest pain and functional dysphagia are the most important manifestations of disturbed esophageal motility. Achalasia is characterized by esophageal aperistalsis and impaired deglutitive relaxation of the lower esophageal sphincter. The morphological correlate is a degeneration of nitrergic neurons in the myenteric plexus. Diagnosis is based on barium esophagram or esophageal manometry with the latter setting the gold standard. Endoscopic exclusion of a tumor at the gastroesophageal junction is mandatory. Appropriate therapeutic interventions are pneumatic dilatation or (laparoscopic myotomy) of lower esophageal sphincter. In patients unfit for these procedures endoscopic injection of botulinum toxin into the lower esophageal sphincter is appropriate. Non-cardiac chest pain may be of esophageal origin. Gastroesophageal reflux, spastic motility disorders and visceral hypersensitivity are arguable underlying mechanisms. The most important diagnostic procedure is 24 h esophageal pH metry correlating symptoms and reflux episodes. Proton pump inhibitors and tricyclic antidepressants serving as visceral analgesics are appropriate therapeutic approaches. Functional dysphagia defines the sensation of impaired passage without mechanical obstruction or a neuromuscular disease with known pathology, e.g. scleroderma. Impaired transit is proven by esophageal scintigraphy or radiogram both using solid boluses. Manometry assesses the underlying mechanisms.
 ...
PMID:[Diagnosis and treatment of esophageal motility disorders]. 1130 49

Non-cardiac chest pain is common,1 affecting around 25% of the population during their lifetime and accounting for about 2-5% of presentations to hospital accident and emergency departments.2 Around 10% of patients presenting with such pain, and up to 13% of those presenting with functional dysphagia, have diffuse oesophageal spasm (DOS), an oesophageal motility disorder.3,4 DOS is often recognised and treated only after patients have attended hospital emergency departments and specialist clinics for years, because of the non-specific nature of their symptoms and difficulty in diagnosis (features common to motility disorders).5 Here we discuss the diagnosis and further management of patients with DOS.
 ...
PMID:Managing diffuse oesophageal spasm. 2154 71