Nutcracker esophagus overview: Difference between revisions
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==Overview== | ==Overview== | ||
Nutcracker esophagus (diffuse esophageal spasm or corkscrew esophagus) is a disorder of the movement of the [[esophagus]], and is one of many [[motility]] disorders of the esophagus, including [[achalasia]] and [[esophageal spasm|diffuse esophageal spasm]]. It causes difficulty swallowing, or [[dysphagia]], to both solid and liquid foods, and can cause [[chest pain]]; it may also have no symptoms. Nutcracker esophagus can affect people of any age, but is more common in the 6th and 7th decades of life. The diagnosis is made by an [[esophageal motility study]], which evaluates the pressure of the esophagus at various points along its length. The term "nutcracker esophagus" comes from the finding of increased pressures during [[peristalsis]], with a diagnosis made when pressures exceed 180 mmHg; this has been linked to the pressure of a mechanical nutcracker. The disorder does not progress, and is not associated with any complications; as a result, treatment of nutcracker esophagus targets control of symptoms only.<ref name=Castell>{{cite journal | author = Tutuian R, Castell D | title = Esophageal motility disorders (distal esophageal spasm, nutcracker esophagus, and hypertensive lower esophageal sphincter): modern management | journal = Curr Treat Options Gastroenterol | volume = 9 | issue = 4 | pages = 283-94 | year = 2006 | id = PMID 16836947}}</ref> | Nutcracker esophagus (diffuse esophageal spasm or corkscrew esophagus) is a disorder of the movement of the [[esophagus]], and is one of many [[motility]] disorders of the esophagus, including [[achalasia]] and [[esophageal spasm|diffuse esophageal spasm]]. It causes difficulty swallowing, or [[dysphagia]], to both solid and liquid foods, and can cause [[chest pain]]; it may also have no symptoms. Nutcracker esophagus can affect people of any age, but is more common in the 6th and 7th decades of life. The diagnosis is made by an [[esophageal motility study]], which evaluates the pressure of the esophagus at various points along its length. The term "nutcracker esophagus" comes from the finding of increased pressures during [[peristalsis]], with a diagnosis made when pressures exceed 180 mmHg; this has been linked to the pressure of a mechanical nutcracker. The disorder does not progress, and is not associated with any complications; as a result, treatment of nutcracker esophagus targets control of symptoms only.<ref name=Castell>{{cite journal | author = Tutuian R, Castell D | title = Esophageal motility disorders (distal esophageal spasm, nutcracker esophagus, and hypertensive lower esophageal sphincter): modern management | journal = Curr Treat Options Gastroenterol | volume = 9 | issue = 4 | pages = 283-94 | year = 2006 | id = PMID 16836947}}</ref> | ||
==Diagnosis== | |||
===Endoscopy=== | |||
Endoscopy is typically normal in patients with nutcracker esophagus; however, abnormalities associated with [[gastroesophageal reflux disease]], or GERD, which associates with nutcracker esophagus, may be seen.<ref name=Bjorkman>{{cite journal | author = Fang J, Bjorkman D | title = Nutcracker esophagus: GERD or an esophageal motility disorder. | journal = Am J Gastroenterol | volume = 97 | issue = 6 | pages = 1556-7 | year = 2002 | id = PMID 12094884}}</ref> Studies on [[endoscopic ultrasound]] show a slight trend towards thickening of the [[esophagus|muscularis propria]] of the esophagus in nutcracker esophagus, but this is not useful in making the diagnosis.<ref>{{cite journal | author = Melzer E, Ron Y, Tiomni E, Avni Y, Bar-Meir S | title = Assessment of the esophageal wall by endoscopic ultrasonography in patients with nutcracker esophagus. | journal = Gastrointest Endosc | volume = 46 | issue = 3 | pages = 223-5 | year = 1997 | id = PMID 9378208}}</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} |
Revision as of 18:20, 20 March 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Nutcracker esophagus (diffuse esophageal spasm or corkscrew esophagus) is a disorder of the movement of the esophagus, and is one of many motility disorders of the esophagus, including achalasia and diffuse esophageal spasm. It causes difficulty swallowing, or dysphagia, to both solid and liquid foods, and can cause chest pain; it may also have no symptoms. Nutcracker esophagus can affect people of any age, but is more common in the 6th and 7th decades of life. The diagnosis is made by an esophageal motility study, which evaluates the pressure of the esophagus at various points along its length. The term "nutcracker esophagus" comes from the finding of increased pressures during peristalsis, with a diagnosis made when pressures exceed 180 mmHg; this has been linked to the pressure of a mechanical nutcracker. The disorder does not progress, and is not associated with any complications; as a result, treatment of nutcracker esophagus targets control of symptoms only.[1]
Diagnosis
Endoscopy
Endoscopy is typically normal in patients with nutcracker esophagus; however, abnormalities associated with gastroesophageal reflux disease, or GERD, which associates with nutcracker esophagus, may be seen.[2] Studies on endoscopic ultrasound show a slight trend towards thickening of the muscularis propria of the esophagus in nutcracker esophagus, but this is not useful in making the diagnosis.[3]
References
- ↑ Tutuian R, Castell D (2006). "Esophageal motility disorders (distal esophageal spasm, nutcracker esophagus, and hypertensive lower esophageal sphincter): modern management". Curr Treat Options Gastroenterol. 9 (4): 283–94. PMID 16836947.
- ↑ Fang J, Bjorkman D (2002). "Nutcracker esophagus: GERD or an esophageal motility disorder". Am J Gastroenterol. 97 (6): 1556–7. PMID 12094884.
- ↑ Melzer E, Ron Y, Tiomni E, Avni Y, Bar-Meir S (1997). "Assessment of the esophageal wall by endoscopic ultrasonography in patients with nutcracker esophagus". Gastrointest Endosc. 46 (3): 223–5. PMID 9378208.