Current Approach to Dysphagia: A Review Focusing on Esophageal Motility Disorders and Their Treatment

被引:3
|
作者
Mascarenhas, Andre [1 ]
Mendo, Rui [1 ]
O'Neill, Catarina [1 ]
Franco, Ana Rita [1 ]
Mendes, Raquel [1 ]
Simao, Ines [1 ]
Rodrigues, Jose Pedro [1 ,2 ]
机构
[1] Ctr Hosp Lisboa Ocidental, Gastroenterol Dept, Lisbon, Portugal
[2] Univ Lisbon, Fac Med, Pathophysiol Autonomous Disciplinary Area, Lisbon, Portugal
关键词
Dysphagia; Esophageal motility; Patient-reported outcomes; PERORAL ENDOSCOPIC MYOTOMY; HIGH-RESOLUTION MANOMETRY; LUMEN IMAGING PROBE; HELLER MYOTOMY; IDIOPATHIC ACHALASIA; MANAGEMENT; OUTCOMES; THERAPY; POEM; SPASM;
D O I
10.1159/000529428
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Dysphagia is a prevalent condition which may severely impact the patient's quality of life. However, there are still lacking standardized therapeutic options for esophageal motility disorders. Summary: Dysphagia is defined as a subjective sensation of difficulty swallowing which can result from oropharyngeal or esophageal etiologies. Regarding esophageal dysphagia, after excluding structural causes and esophageal mucosal lesions, high-resolution manometry (HRM) is the gold standard for the diagnosis of esophageal motility disorders. HRM has not only improved the sensitivity for detecting achalasia but has also expanded our understanding of spastic and hypomotility disorders of the esophageal body. The Chicago Classification v4.0 uses a hierarchical approach and provides a standardized diagnosis of esophageal motility disorders, allowing a tailored therapeutic approach. Dysphagia is often a long-term health problem that broadly impacts health and well-being and leads to physical and psychosocial disability, namely, malnutrition and aspiration pneumonia, as well as social isolation, depression, and anxiety. Apart from achalasia, most esophageal motility disorders tend to have a benign long-term course with symptoms of dysphagia and noncardiac chest pain that can improve significantly over time. Patient-reported outcomes (PROs) are self-assessment tools that capture the patients' illness experience and help providers better understand symptoms from the patients' perspective. Therefore, PROs have a critical role in providing patient-centered care. Key Messages: Motility disorders should be ruled out in the presence of nonobstructive esophageal dysphagia, and treatment options should be considered according to the severity of symptoms reported by the patient.
引用
收藏
页码:403 / 413
页数:11
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