Non-#achalasia #motility disorders of the #esophagus with @RenaYadlapati
#MedTwitter #GITwitter #ACG2022
#MedTwitter #GITwitter #ACG2022
Esophageal #motility
Esophageal physiology testing
Perform high-resolution esophageal manometry in patients with non-obstructive symptoms 🌈
Start with the IRP (reflects LES relaxation)
Chicago classification v4.0: disorders of EGJ outflow
#Achalasia
Type I: "sea of blue"
Type II: panesophageal pressurization; perhaps a precursor to type I or even 3
Type III: spastic achalasia
Type I: "sea of blue"
Type II: panesophageal pressurization; perhaps a precursor to type I or even 3
Type III: spastic achalasia
🧇EGJ outflow obstruction #EGJOO
⚠️Some are clinically irrelevant, but others may benefit from LES-directed therapies
⚠️Some are clinically irrelevant, but others may benefit from LES-directed therapies
If EGJOO: do they have symptoms?
🧇Treatment of #EGJOO: treat to target the underlying mechanism
Chicago classification v4.0: disorders of peristalsis
Distal esophageal spasm and hypercontractile esophagus
💡Needs to be clinically relevant!
💡Needs to be clinically relevant!
DES/HE represents many different pathologies
💡#GERD often accompanies these motor patterns
💡#GERD often accompanies these motor patterns
Treatment of DES/HE
Absent contractility and ineffective esophageal motility
💡Often found in mixed connective tissues disorders (e.g., scleroderma)
💡Often found in mixed connective tissues disorders (e.g., scleroderma)
Treatment of IEM and absent contractility
🔑Summary from @RenaYadlapati
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