Looking for one paper to summarize how to diagnose & treat all the different esophageal motility disorders?
Here is a tweetorial on all the highlights from our recent publication (along w/ @RenaYadlapati) in @AGA_Gastro!
@AmerGastroAssn #GITwitter
doi.org
Here is a tweetorial on all the highlights from our recent publication (along w/ @RenaYadlapati) in @AGA_Gastro!
@AmerGastroAssn #GITwitter
doi.org
2/ Clinical presentation:
-Dysphagia to solids and/or liquids
-Atypical chest pain (always rule out cardiac etiology first)
--Only 1-2% of pts undergoing HRM and CP have a spatic d/o
--1 person dies every 36 seconds in US from MI
Here are the diagnostic tools @AGA_Gastro :
-Dysphagia to solids and/or liquids
-Atypical chest pain (always rule out cardiac etiology first)
--Only 1-2% of pts undergoing HRM and CP have a spatic d/o
--1 person dies every 36 seconds in US from MI
Here are the diagnostic tools @AGA_Gastro :
3/ HRM is the gold standard test for motility evaluation.
-Apply Chicago classification v 4.0!
-We tried to make it simpler by adding actually HRM tracings to the classification
@AGA_Gastro
-Apply Chicago classification v 4.0!
-We tried to make it simpler by adding actually HRM tracings to the classification
@AGA_Gastro
4/ Achalasia is the classic esophageal motility disorder that can't be missed due to great treatment options!
First line options:
-PD, POEM, and LHM.
-POEM preferred for type III
If not a candidate:
-Botox
First line options:
-PD, POEM, and LHM.
-POEM preferred for type III
If not a candidate:
-Botox
5/ For non-achalasia motility disorders, reflux evaluation should be considered first.
Here is the algorithm @AGA_Gastro !
Here is the algorithm @AGA_Gastro !
6/ If chest pain is the primary symptom, neuromodulators or smooth muscle relaxers are excellent options.
What drugs to use and what is the evidence behind them (very little)? Here is what we propose @AGA_Gastro
What drugs to use and what is the evidence behind them (very little)? Here is what we propose @AGA_Gastro
7/ Lastly, remember that esophageal motility disorders can also be due to systemic conditions (connective tissue disease or drugs such as opioids) or mucosal inflammation (EoE).
-Stopping opioids can help improve symptoms & motility findings
-Treating EoE (if present)
-Stopping opioids can help improve symptoms & motility findings
-Treating EoE (if present)
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