Oesophageal Motor Disorders

The dilated cardiomyopathy is an esophageal dyskinesia characterized by decreased or loss of esophageal motility, and the sphincter sphincter does not open in response to swallowing reflex. Most patients experience difficulty swallowing and reflux with a slow and gradual onset, so that there are cases of patients coming to the hospital late when the symptoms are clear.
Difficulty swallowing and reflux are common signs
Most patients experience difficulty swallowing and reflux with a slow and gradual onset, so that there are cases of patients coming to the hospital late when the symptoms are clear. Swallowing is difficult with food and water, and the swallowing sensation is often behind the breastbone, sometimes spreading to the pharynx.
Reflux usually appears soon after eating, but sometimes backwards with undigested food after eating for hours

. Other manifestations may also be encountered such as weight loss, coughing, hiccups, heartburn, chest pain, pneumonia, reflux ..
So far, the cause of the disease is unknown, but the disease is related to two characteristics of the esophagus, the first is the inotropic action to push food down the esophagus, the second is sphincter sphincter.



The dilated lower esophagus creates a barrier that prevents food and drink from the esophagus from reaching the stomach.
It has been found that one of the main reasons why the lower esophageal sphincter does not relax is due to damage to nerve cells in response to esophageal muscle relaxation, on the other hand due to balance disorders. Exciting neurotransmitters and inhibitors of peristalsis control of the esophagus and sphincter sphincter.
It should be distinguished from pathologies with similar signs
Diagnosis of the disease is based on the aforementioned clinical manifestations and tests, noting that it is necessary to make a differential diagnosis from pathologies with similar symptoms that can cause confusion such as gastroesophageal reflux disease, tumors, esophageal cancer ...
Tests that need to be done, such as X-ray esophagus x-rays, are simple tests that are easy to perform, feature images of an enlarged esophagus, and then narrow in the lower segment - a 'radish' sign , 'bird beak'.



X-ray irradiation helps to evaluate the movement of the esophagus so that the esophageal motility decreases.
Endoscopy of the esophagus helps to directly observe the lining of the esophagus, the mind and the stomach. Direct observation of lesions is an advantage of endoscopy, in addition to helping diagnose diagnosis, it also helps to distinguish other injuries such as tumors, esophageal cancer, stomach, etc. Make anatomical diagnosis when necessary.
See more: Discount 25% for gastrointestinal cancer screening
Patients should be treated like?
Patients with this condition need appropriate lifestyle changes such as eating slowly, chewing thoroughly, eating liquid food, avoiding eating right away, and sleeping with knee-high head. Regular checkups to avoid complications such as reflux disease, ulcers, and even esophageal cancer.
Medical treatment usually uses calcium channel blockers such as nifedipine and nitrate groups such as isosorbide dinitrate, nitroglycerin; they effectively relieve lower esophageal sphincter pressure. Priority is usually given to elderly patients with contraindications to surgery or surgery or to patients awaiting surgery.




However, the drug usually reduces its effect after a period of treatment and has many side effects, especially in patients with cardiovascular disease.
Procedures such as botulinum toxin injection into the lower esophageal sphincter, botulinum have been shown to reduce muscle spasms, help balance excitement, and inhibit the control of the lower esophageal sphincter.
The disadvantage of this method is that it can cause inflammation, muscle fibrosis and thus make it difficult for surgery in the future, usually only treatment for elderly patients who are not able to operate. The procedure of endoscopic esophageal dilatation for the success rate is relatively high, however, the rate of dilatation is also large, about 50%, the common complication after dilatation is gastroesophageal reflux.
Surgery is the best option, the choice of laparoscopic or open surgery depends on the individual patient.
MSc. Le Quang Duc.

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