Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Neurogastroenterol Motil. 2020 Nov;32(11):e14010. doi: 10.1111/nmo.14010. Epub 2020 Oct 11.
Hypercontractile esophagus (HE), also known as jackhammer esophagus, is an esophageal motility disorder. Nowadays, high-resolution manometry (HRM) is used to diagnose the disorder. According to the latest iteration of the Chicago classification, HE is present when at least 2 out 10 liquid swallow-induced peristaltic waves have an abnormally high Distal Contractile Integral. In the era of conventional manometry, a similar condition, referred to as nutcracker esophagus, was diagnosed when the peristaltic contractions had an abnormally high mean amplitude. Although the HRM diagnosis of HE is relatively straight-forward, effective management of the disorder is challenging as the correlation with symptoms is variable and treatment effects are dubious. In this mini-review, we discuss the most troublesome uncertainties that still surround HE, in the light of new data on etiology and epidemiology published in this issue of Neurogastroenterology and Motility.
高收缩性食管（HE），又称“痉挛性食管”，是一种食管动力障碍。目前，高分辨率测压法（HRM）被用于诊断该疾病。根据芝加哥分类的最新迭代，当至少 10 次液体吞咽诱发的蠕动波中，有 2 次以上的远段收缩积分异常高时，即可诊断为 HE。在常规测压法时代，当蠕动收缩的平均幅度异常高时，类似的情况被称为“胡桃夹食管”。虽然 HRM 对 HE 的诊断相对直接，但由于其与症状的相关性存在变数，且治疗效果也存在争议，因此该疾病的有效管理颇具挑战。在本篇迷你综述中，我们将根据本刊发表的有关病因学和流行病学的新数据，讨论仍围绕 HE 的最棘手的不确定性问题。
