Esophageal spasm: demographic, clinical, radiographic, and manometric features in 108 patients
Autor: | C, Almansa, M G, Heckman, K R, DeVault, E, Bouras, S R, Achem |
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Rok vydání: | 2011 |
Předmět: |
Adult
Male Chest Pain Delayed Diagnosis Esophageal pH Monitoring Time Factors Manometry Statistics Nonparametric Young Adult Esophagus Weight Loss Humans Aged Aged 80 and over Psychotropic Drugs Mental Disorders Proton Pump Inhibitors Middle Aged Esophageal Spasm Diffuse Radiography Histamine H2 Antagonists Hypertension Gastroesophageal Reflux Female Antacids Esophagoscopy Deglutition Disorders Gastrointestinal Motility |
Zdroj: | Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 25(3) |
ISSN: | 1442-2050 |
Popis: | Diffuse esophageal spasm (DES) remains insufficiently understood. Here we aimed to summarize the demographic, clinical, radiographic, and manometric features in a large cohort of patients with DES. We identified all consecutive patients diagnosed with DES from 2000 to 2006 at Mayo Clinic Florida. The computerized records of these patients were reviewed to extract relevant information. We performed 2654 esophageal motilities during that period. There were 108 patients with esophageal spasm, and 55% were female. Median age was 71 years. The most common leading symptom was dysphagia in 55, followed by chest pain in 31. Weight loss occurred in 28 patients. The median of time from onset of symptoms to diagnosis was 48 months (range 0-480), with a median of time from the first medical consultation to diagnosis of 8 months (range 0-300). The most frequent comorbidities were hypertension and psychiatric problems. At presentation, 81 patients were taking acid-reducing medications, and 49 patients were taking psychotropic drugs. An abnormal esophagogram was noted in 46 of 76 patients with this test available, but most radiographic findings were nonspecific with the typical 'corkscrew' appearance seen in only three patients. Gastroesophageal reflux disease (GERD) was diagnosed by pH testing or endoscopy in 41 patients. We did not find any difference between the rate of simultaneous contractions or esophageal amplitude between patients with a leading symptom of dysphagia and those with chest pain. DES is an uncommon motility disorder that often goes unrecognized for years. Physicians should be aware of the clinical heterogeneity of DES and consider motility testing early in the course of unexplained esophageal symptoms. Given the high prevalence of GERD in DES, the role of GERD and the impact of acid-reducing therapy in DES deserve further study. |
Databáze: | OpenAIRE |
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