Oesophageal motility disorders

Oesophageal motility disorders comprise various abnormal manometric pattern s which usually present with dysphagia or chest pain. Some, such as achalas ia, are diseases with a well defined pathology, characteristic manometric f eatures, and good response to treatments directed at the pathophysiological abnormalities. Other disorders, such as diffuse oesophageal spasm and hype rcontracting oesophagus, have no well defined pathology and could represent a range of motility changes associated with subtle neuropathic changes, ga stro-oesophageal reflux, and anxiety states. Although manometric patterns h ave been defined for these disorders, the relation with symptoms Is poorly defined and the response to medical or surgical therapy unpredictable. Hypo contracting oesophagus Is generally caused by weak musculature commonly ass ociated with gastro-oesophageal reflux disease. Secondary oesophageal motil ity disorders can be caused by collagen vascular diseases, diabetes, Chagas ' disease, amyloidosis, alcoholism, myxo-oedema, multiple sclerosis, Idiopa thic pseudo-obstruction, or the ageing process.