Distension‐contraction profile of peristalsis in patients with nutcracker esophagus

Author(s):  
Ali Zifan ◽  
Kazumasa Muta ◽  
Ravinder K. Mittal
Keyword(s):  
1986 ◽  
Vol 31 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Joel E. Richter ◽  
W. Fred Obrecht ◽  
Laurence A. Bradley ◽  
Larry D. Young ◽  
Karen O. Anderson

2009 ◽  
Vol 10 (2) ◽  
pp. AB38
Author(s):  
R. Goubraim ◽  
I. Serraj ◽  
L. Amrani ◽  
M. Nya ◽  
N. Amrani

1985 ◽  
Vol 30 (2) ◽  
pp. 188-188 ◽  
Author(s):  
Joel E. Richter ◽  
Wallace C. Wu ◽  
Robert J. Cowan ◽  
David J. Ott ◽  
John N. Blackwell
Keyword(s):  

1993 ◽  
Vol 265 (6) ◽  
pp. G1098-G1107 ◽  
Author(s):  
R. E. Clouse ◽  
A. Staiano

Topographic plots were created from esophageal manometric tracings in 12 asymptomatic volunteers and 10 symptomatic patients with high-amplitude peristaltic contraction waves (nutcracker esophagus) to identify segmental contraction differences between the two groups. Median waves at each centimeter of esophageal length were spatially interconnected using a computerized gridding and plotting system, and a characteristic peristaltic contraction from the proximal esophageal body through the lower sphincter was constructed for each subject. Contour plots in the volunteers revealed three amplitude troughs dividing the peristaltic contraction into four sequential segments: the skeletal muscle body, the proximal and distal segments of the smooth muscle body, and the lower sphincter region. In nutcracker-esophagus patients, only the first and third troughs could be identified, since augmented contraction in the distal smooth muscle segment blurred separation of the smooth muscle body segments. Volume measurements under the topographic plots showed no significant intergroup differences in contraction of the skeletal muscle region or lower sphincter but modest increase in contraction of the proximal smooth muscle segment [1.7 times normal, 95% confidence interval (CI) 1.2-2.0; P = 0.002 comparing 2 groups] and marked increase in the distal smooth muscle segment (2.7 times normal, 95% CI 2.0-3.3; P < 0.0001). These data indicate that normal peristalsis through the esophageal body and lower sphincter includes four separate contraction segments that can be distinguished with intraluminal manometry and the topographic analysis method. The nutcracker esophagus primarily affects the distal segment in the smooth muscle body.


1991 ◽  
Vol 5 (2) ◽  
pp. 51-57 ◽  
Author(s):  
William G Paterson ◽  
Delia A Marciano-D’Amore ◽  
Ivan T Beck ◽  
Laurington R Da Costa

In a five year period 238 of 594 esophageal manometric studies performed in the authors’ laboratory were done on patients whose major reason for referral was noncardiac angina-like chest pain. Standard eophageal manometry was performed followed by an acid-antacid perfusion period (Bernstein test) and then subcutaneous bethanechol (80 μg/kg to a maximum of 5 mg) was adminstered. Baseline manometry was normal in 38% of patients and was diagnostic of ‘nutcracker’ esophagus, nonspecific esophageal motility disorder, diffuse esophageal spasm and isolated hypertensive lower esophageal sphincter in 24%, 19%, 16% and 3% of patients, respectively. Ninety-six of 238 patients (40%) experienced reproduction of their presenting angina-like chest pain during acid perfusion. In 80% of these patients there were associated esophageal motor abnormal ilies induced by the acid perfusion. Thirty-six of 212 (17%) experienced pain reproduction following the injection of bethanechol; however, 16 of these had already had their presenting chest pain reproduced during the acid perfusion study. In two-thirds of the patients with pain reproduction following bechanechol there was an associated bethanechol-induced esophageal motility disorder. Overall 49% of patients had their pain reproduced during provocative testing. The acid perfusion test reproduced the pain much more frequently than bethanechol simulation. This study reaffirms the value of esophageal manometry and provocative testing in this group of patients.


1986 ◽  
Vol 8 (3 Part 1) ◽  
pp. 230-232 ◽  
Author(s):  
Sarkis J. Chobanian ◽  
David J. Curtis ◽  
Stanley B. Benjamin ◽  
Edward L. Cattau
Keyword(s):  

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