Adler D G, Romero Y
Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic, Rochester, Minn. 55905, USA.
Mayo Clin Proc. 2001 Feb;76(2):195-200. doi: 10.1016/S0025-6196(11)63127-3.
Esophageal motility disorders often manifest with chest pain and dysphagia. Achalasia is a disorder of the lower esophageal sphincter and the smooth musculature of the esophageal body. In achalasia the lower esophageal sphincter 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. Pseudoachalasia mimics achalasia in terms of symptoms but can be caused by infectious disorders or malignancy. Treatment for achalasia is nonstandardized and includes medical, endoscopic, and surgical options. Spastic disorders of the esophagus, such as diffuse esophageal spasm and nutcracker esophagus, and nonspecific esophageal motility disorder are benign and nonprogressive, with similar findings on esophageal manometry. Although the exact cause remains unknown, these disorders may represent a manifestation of gastroesophageal reflux disease. Treatment of spastic disorders includes medical and surgical approaches and is aimed at symptomatic relief.
食管动力障碍常表现为胸痛和吞咽困难。贲门失弛缓症是一种食管下括约肌和食管体平滑肌的疾病。在贲门失弛缓症中，食管下括约肌通常在吞咽时不能松弛，且食管体不能进行蠕动。与食管痉挛性疾病不同，贲门失弛缓症可呈进行性发展并导致明显的发病率。假性贲门失弛缓症在症状方面模仿贲门失弛缓症，但可由感染性疾病或恶性肿瘤引起。贲门失弛缓症的治疗不规范，包括药物、内镜和手术选择。食管痉挛性疾病，如弥漫性食管痉挛和胡桃夹食管，以及非特异性食管动力障碍是良性且非进行性的，在食管测压上有相似表现。尽管确切病因尚不清楚，但这些疾病可能是胃食管反流病的一种表现。痉挛性疾病的治疗包括药物和手术方法，旨在缓解症状。
