Transition from nutcracker esophagus to achalasia

Anggiansah, Angela; Bright, N; McCullagh, Majella; Owen, William J.

doi:10.1007/bf01537590

Cited by 45 publications

(26 citation statements)

References 17 publications

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“…[11][12][13][14][15] There is no sufficient data to prove whether GERD progresses to achalasia. There are several case reports describing the progression of GERD to achalasia.…”

Section: Does Gastroesophageal Reflux Disease Really Progress To Achamentioning

confidence: 99%

Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

Jung

Park

2017

J Neurogastroenterol Motil

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Achalasia and gastroesophageal reflux disease (GERD) are on opposite ends of the spectrum of lower esophageal sphincter dysfunction. Heartburn is the main symptom of GERD. However, heartburn and regurgitation are frequently observed in patients who have achalasia. The diagnosis of achalasia might be delayed because these symptoms are misinterpreted as gastroesophageal reflux. Here, we reviewed the clinical characteristics of patients with the erroneous diagnosis of GERD who actually had untreated achalasia.

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“…[11][12][13][14][15] There is no sufficient data to prove whether GERD progresses to achalasia. There are several case reports describing the progression of GERD to achalasia.…”

Section: Does Gastroesophageal Reflux Disease Really Progress To Achamentioning

confidence: 99%

Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

Jung

Park

2017

J Neurogastroenterol Motil

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“…Nutcracker esophagus is not well described in children. There is one case report of a child with high intra-esophageal pressures who progressed to achalasia [Angiannsah et al, 1990]. He was aged 11 years at presentation and symptoms had been present for only 1 year.…”

Section: Discussionmentioning

confidence: 98%

Esophageal dysmotility in brothers with an FG-like syndrome

et al. 2000

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We present 4 brothers with developmental delay, minor anomalies, and symptoms due to gastrointestinal dysmotility. There was some resemblance with FG syndrome, although none of the brothers had sufficient findings to make this diagnosis. The index case presented with at age 1 month with screaming episodes, mild gastro-esophageal reflux (GER), and severe constipation. Esophageal manometry studies were consistent with the diagnosis of "nutcracker esophagus." Symptomatic and manometric improvement followed treatment with oral calcium channel blockers. Two older and less severely affected brothers had similar manometric findings but did not require treatment. A fourth brother with symptoms in infancy now has normal esophageal manometry findings. These boys in all likelihood have an X-linked syndrome with manifestations of FG syndrome, in which treatment with calcium channel blockers, produces clinical and manometric improvement. The FG syndrome is an X-linked syndrome of multiple congenital anomalies/mental retardation with facultative manifestations of gastrointestinal dysmotility, including gastro-esophageal reflux, severe feeding difficulties, and constipation. Esophageal dysmotility, in particular "nutcracker esophagus," should be suspected in infants with the FG syndrome and screaming attacks.

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“…Anggiaansah et al 1 relataram um caso que evoluiu de esôfago em quebra-nozes para acalásia. Vantrappen et al 15 , por sua vez, relataram seis pacientes com distúrbio motor inespecífico com esta progressão.…”

Section: Discussionunclassified

Evolução motora incomum na doença do refluxo gastroesofágico

Mendes-Filho

Medeiros

Silveira

et al. 2010

ABCD, arq. bras. cir. dig.

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DESCRITORES -Acalásia esofágica. Refluxo gastroesofágico. Espasmo esofagiano difuso.RESUMO -Introdução -Demonstra-se que os distúrbios motores esofágicos como o espasmo esofageano difuso podem progredir para acalásia. Também é conhecida a associação entre a doença do refluxo gastroesofágico e alguns destes distúrbios.Relato do caso -Paciente com queixa de dor torácica, disfagia e perda de peso há dois meses. A primeira endoscopia digestiva alta sugeriu apenas dismotilidade esofágica. Posteriormente, realizou manometria esofágica que evidenciou alterações em corpo compatíveis com espasmo esofageano difuso, sem alterações no esfíncter esofageano inferior. Na oportunidade iniciou o tratamento com pantoprazol e nifedipina que se estendeu por oito meses; no entanto manteve-se sintomática. Após suspender medicação por 10 dias, realizou pH-metria esofageana prolongada constatando-se refluxo gastroesofágico patológico combinado e refluxo proximal, sendo submetida ao tratamento com esomeprazol e mantida a nifedipina. Após dois meses, com a persistência dos sintomas, realizou-se nova endoscopia que evidenciou estase alimentar e manometria esofágica com aperistalse completa de corpo. Neste momento, optou-se por cardiomiotomia a Heller com fundoplicatura laparoscópica. A endoscopia do terceiro mês do pós-operatório evidenciou fundoplicatura bem ajustada ao aparelho. No seguimento a médio prazo ela permanece assintomática. Conclusão -Existe correlação entre os distúrbios motores esofágicos e a doença do refluxo gastroesofágico, e o tratamento cirúrgico para corrigir a acalásia e o refluxo gastroesofágico ao mesmo tempo, pode ser indicado em casos selecionados.ABSTRACT -Background -It is shown that esophageal motor disorders, such as diffuse esophageal spasm, may progress to achalasia. It is also known a link between gastroesophageal reflux disease and some of these motor disorders. Case report -Patient complaining of chest pain, dysphagia and weight loss for two months. The first endoscopy suggested only motility disorders. Esophageal manometry was done and showed changes in body compatible with diffuse esophageal spasm, without changes in lower esophageal sphincter. Treatment with pantoprazole and nifedipine for eight months was done, but the patient remained symptomatic. After stopping medication for 10 days, an esophageal pH-metry was realized and showed gastro-esophageal reflux. She was submitted to treatment with esomeprazole and nifedipine. After two months, with persistence of the symptoms, a new endoscopy showed food stasis, and esophageal manometry body esophageal aperistalsis. At this point, surgical treatment (Heller cardiomyotomy with fundoplication) was done. Endoscopy of the third postoperative month showed fundoplication well adjusted to the endoscope. In follow-up, patient remained asymptomatic. ConclusionThere is a correlation between esophageal motor disorders and gastroesophageal reflux disease, and surgical treatment to correct achalasia and gastroesophageal reflux at the same time, may be indicated in se...

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Transition from nutcracker esophagus to achalasia

Cited by 45 publications

References 17 publications

Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

Is Gastroesophageal Reflux Disease and Achalasia Coincident or Not?

Esophageal dysmotility in brothers with an FG-like syndrome

Evolução motora incomum na doença do refluxo gastroesofágico

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