Esophageal motility disorder: The Daily PANCE Blueprint
A 52-year-old male presents with intermittent chest pain and difficulty swallowing liquids. Symptoms occur sporadically and are not related to exertion. He also reports heartburn and a persistent globus sensation. Which of the following conditions best explains this patient’s symptoms?
A. Achalasia
B. Coronary artery disease
C. Esophageal motility disorder
D. Gastroesophageal reflux disease
E. Esophageal stricture
Answer and topic summary
The answer is C. Esophageal motility disorder
Esophageal motility disorders are a group of conditions characterized by abnormal contractions of the esophagus. It includes hypercontractile esophagus (jackhammer esophagus), hypertensive peristalsis (nutcracker esophagus), and distal esophageal spasm (aka corkscrew esophagus). Clinical features include intermittent dysphagia to liquid, chest pain, heartburn, globes sensation, upper respiratory symptoms, etc. Work-up includes upper endoscopy, esophageal barium swallow, and manometry. Treatment for acute episodes includes smooth muscle relaxants (like nifedipine or sildenafil), peppermint oil, and tricyclic antidepressants. Endoscopic botox injections or surgery can be done for refractory cases.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ ⇒
