Nutcracker Esophagus

The nutcracker esophagus is a hypercontractile motility disorder of the muscles of the lower esophagus ( pars abdominalis ), which is manifested by spastic contractions of the esophagus. The cause of the symptom is unknown.

Epidemiology

The exact frequency is not known. In larger patient collections a Nutcracker was esophagus in 12% of patients with non- cardiac chest pain detected. Overall, however, the data is too small to be able to make a well-founded statement.

Symptoms

The generally difficult act of swallowing ( dysphagia ) is accompanied by spastic cramps in the esophagus in the nutcracker esophagus. Food can only be consumed with severe pain, although the frequency and location of the maximum pain can vary. The pain, often described as angina pectoris-like , is often projected between the shoulder blades and into the jaw area.

diagnosis

In addition to radiological imaging procedures ( double contrast method ), an esophageal manometry is used. A nutcracker esophagus is defined here by contraction amplitudes that are greater than 2 standard deviations of normal amplitudes (height about 180 mmHg). An esophageal swallow indicates propulsive activity. An endoscopy is inconspicuous, but should be conducted to other diseases of the esophagus ( esophagitis excluded erosive reflux disease etc.).

therapy

It is conservatively treated with calcium channel blockers and muscarinic receptor antagonists such as butylscopolamine or nifedipine intravenously . Nitrates such as glycerol trinitrate can also be used for esophageal spasms. The administration of antidepressants can also relieve the symptoms. If drug therapy fails, an esophagomyotomy can be performed (laparoscopic or thoracoscopic). Nitro supplements can be used during a seizure .

See also

• Diffuse esophageal spasm

Individual evidence

1. ↑ ^{a b c d} J. H. Schneider: Motility disorders of the esophagus . Georg Thieme Publishing House. Stuttgart 2004. ISBN 3-13-1293616 , p. 91ff
2. ↑ ^{a b c d} H. Messmann: Clinical gastroenterology . Georg Thieme Publishing House. Stuttgart 2011 ISBN 3-13-1472510 , pp. 155f
3. ↑ G. Bartolome et al. a .: Swallowing disorders: diagnosis and rehabilitation . 5th edition. Urban & Fischer Verlag 2013. ISBN 978-3437444166 , p. 443
4. ^ Peter Reuter: Clinical Dictionary. 1st edition, Springer-Medizin-Verlag Heidelberg, 2007, p. 1349

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !