Gastroenterology Book

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Esophageal AchalasiaAka: Cardiospasm

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  1. Pathophysiology
    1. Deficient distal esophagus cholinergic innervation
    2. Loss of normal peristalsis
    3. Lower Esophageal Sphincter (LES) dysfunction
      1. LES Incoordinate contraction
      2. LES tonic contractions
      3. Constriction of LES in response to swallowing
  2. Symptoms
    1. Dysphagia
    2. Regurgitation of food, Saliva, esophageal secretions
  3. Signs
    1. Weight loss
  4. Radiology: Upper GI
    1. Esophageal dilatation
    2. Beadlike narrowing of distal segment
    3. Spasm of lower esophageal sphincter
  5. Diagnosis: Esophageal Manometry
    1. Intraluminal pressure
    2. pH
    3. Transit time
  6. Management
    1. Consider trial on antispasmodic for Esophageal Spasm
      1. Nifedipine 10 mg capsule
        1. Bite and swallow capsule 30 minutes before meal
    2. Surgical Interventions
      1. Balloon Esophageal Dilatation
      2. Cardiomyotomy
      3. Botulinum toxin

Esophageal achalasia (C0014848)

Definition (MSH)A motility disorder of the ESOPHAGUS in which the LOWER ESOPHAGEAL SPHINCTER (near the CARDIA) fails to relax resulting in functional obstruction of the esophagus, and DYSPHAGIA. Achalasia is characterized by a grossly contorted and dilated esophagus (megaesophagus).
Definition (CSP)failure of normal relaxation of the lower esophageal sphincter associated with uncoordinated contractions of the thoracic esophagus, resulting in functional obstruction and difficulty swallowing.
ConceptsDisease or Syndrome (T047)
ICD9530.0, 530.0
MSHD004931
EnglishAchalasia, ACHALASIA & CARDIOSPASM, Achalasia and cardiospasm, ACHALASIA CARDIAE, ACHALASIA ESOPHAGEAL, Achalasia of cardia, Achalasia of esophagus, Achalasia of oesophagus, cardiospasm, Cardiospasms, Esophageal achalasia, Esophageal Achalasias, Hypertensive lower esophageal sphincter, Hypertensive lower oesophageal sphincter, Lack of reflex relaxation of lower esophageal sphincter, Lack of reflex relaxation of lower oesophageal sphincter, Megaoesophagus
Spanishacalasia del cardias, acalasia del esofago, ausencia del reflejo de relajacion del esfinter esofagico inferior, cardioespasmo, esfinter esofagico inferior hipertensivo, hipertension del esfinter esofagico inferior
Parent ConceptsEsophageal Diseases (C0014852), GASTRIC/DUODENAL (C0549614), Esophageal motility disorders (C0014858), Stomach Diseases (C0038354), Reason not stated concept (C1276325), Disorder of smooth muscle (C1290162), Duplicate concept (C1274013)
SourcesAOD, CSP, CST, DXP, ICD9CM, LCH, MSH, MTH, MTHICD9, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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