Other oesophageal motility disorders

Diffuse oesophageal spasm

Diffuse oesophageal spasm is a motility disorder of unknown cause and pathophysiology. Diffuse oesophageal spasm usually presents in late middle age with episodic chest pain, which may mimic angina, but is sometimes accompanied by transient dysphagia. Some cases occur in response to gastro-oesophageal reflux. Treatment is based upon the use of proton pump inhibitors when gastro-oesophageal reflux is present. Results of drug therapy are often disappointing and the alternatives of pneumatic dilation and surgical myotomy are also poor.

Benign oesophageal stricture

An oesophageal stricture is an abnormal formation of fibrous tissue in the oesophagus. Progressive dysphagia is the most common clinical feature. To exclude malignancy as the cause of the stricture, endoscopic examination and multiple biopsies are required. A benign oesophageal stricture is usually the consequence of GORD and occurs most often in older patients who have poor oesophageal clearance.

Oesophageal varices See Chapter 7, The Liver.

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