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Query: UMLS:C0014848 (achalasia)
 2,804 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with vigorous achalasia is presented who had marked smooth muscle hypertrophy and eosinophilic infiltration of the esophagus identical to that seen in patients with eosinophilic gastroenteritis. Eosinophilic infiltration of the esophagus probably represents a variant of the eosinophilic gastroenteritis syndrome and may predispose to an esophageal motor disorder.
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PMID:Eosinophilic esophagitis in a patient with vigorous achalasia. 64 22

Eosinophilic gastroenteritis is an unusual disease entity characterized by eosinophilic infiltration of the gut with gastrointestinal disturbance. The disease commonly involves the stomach and small bowel. Esophageal involvement is rarely reported. We present a patient with simultaneous achalasia, pyloric stenosis, and ascites. Macroscopically, the esophagus, stomach and small intestine were involved. Microscopically, the mucosa was involved to the serosa. The patient has remained well under low dose prednisolone treatment for 7 years since his condition was diagnosed.
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PMID:Eosinophilic gastroenteritis with esophageal involvement. 868 8

Eosinophilic esophagitis (EoE), a disorder identified by its esophageal mucosal features, often is associated with esophageal motility abnormalities, which are manifestations of esophageal muscle dysfunction. Those motility abnormalities sometimes normalize with treatments that reduce esophageal eosinophilia, suggesting that eosinophils can cause reversible esophageal motility disturbances, perhaps by releasing myoactive and neuroactive eosinophil products. Although achalasia uncommonly is associated with EoE as currently defined, most achalasia patients have evidence of an abnormal accumulation of eosinophils and/or their degranulation products in the esophageal muscularis propria, a location inaccessible to routine endoscopic evaluation. Achalasia is an idiopathic condition resulting from destruction of neurons in the myenteric plexus of the esophagus, and degranulating eosinophils release toxic proteins capable of destroying those neurons, thereby causing the irreversible motility abnormalities of achalasia. This report reviews data on the association of esophageal eosinophilia with achalasia and other esophageal motility abnormalities. Based on this review, we propose that EoE, like eosinophilic gastroenteritis, might have mucosal-predominant and muscle-predominant forms with different clinical manifestations. A muscle-predominant form of EoE could underlie a variety of reversible and irreversible esophageal motility disorders, including achalasia. The concept that esophageal motility abnormalities might develop from a muscle-predominant form of EoE warrants serious consideration and further investigation.
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PMID:Can Eosinophilic Esophagitis Cause Achalasia and Other Esophageal Motility Disorders? 3031 8

This report explores two hypotheses regarding eosinophilic esophagitis (EoE): (1) that the use of proton pump inhibitors (PPIs) might contribute to the pathogenesis of EoE by preventing peptic digestion of food allergens, by increasing gastric mucosal permeability to enable gastric absorption of those undegraded food allergens, and by causing microbial dysbiosis, and (2) that EoE, like eosinophilic gastroenteritis, might have mucosal-predominant and muscle-predominant forms, and that the muscle-predominant form of EoE might cause a variety of esophageal motility disorders including achalasia.
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PMID:Eosinophilic esophagitis: novel concepts regarding pathogenesis and clinical manifestations. 3134 46