Primary esophageal motility disorders

Esophageal motility disorders often manifest with chest pain and dysphagia. Achalasia is a disorder of the lower esophageal sphincter and the smooth m usculature of the esophageal body. In achalasia the lower esophageal sphinc ter typically fails to relax with swallowing, and the esophageal body fails to undergo peristalsis, In contrast to spastic disorders of the esophagus, achalasia can be progressive and cause pronounced morbidity. Pseudoachalas ia mimics achalasia in terms of symptoms but can be caused by infectious di sorders or malignancy. Treatment for achalasia is nonstandardized and inclu des medical, endoscopic, and surgical options, Spastic disorders of the eso phagus, such as diffuse esophageal spasm and nutcracker esophagus, and nons pecific esophageal motility disorder are benign and nonprogressive, with si milar findings on esophageal manometry, Although the exact cause remains un known, these disorders may represent a manifestation of gastroesophageal re flux disease. Treatment of spastic disorders includes medical and surgical approaches and is aimed at symptomatic relief.