Esophageal disorders

Qasim Aziz, Ronnie Fass, C. Prakash Gyawali, Hiroto Miwa, John E. Pandolfino, Frank Zerbib

Research output: Contribution to journalArticle

165 Scopus citations

Abstract

Functional esophageal disorders consist of a disease category that presents with esophageal symptoms (heartburn, chest pain, dysphagia, globus) that are not explained by mechanical obstruction (stricture, tumor, eosinophilic esophagitis), major motor disorders (achalasia, esophagogastric junction outflow obstruction, absent contractility, distal esophageal spasm, jackhammer esophagus), or gastroesophageal reflux disease. Although mechanisms responsible are unclear, it is theorized that visceral hypersensitivity and hypervigilance play an important role in symptom generation, in the context of normal or borderline function. Treatments directed at improving borderline motor dysfunction or reducing reflux burden to subnormal levels have limited success in symptom improvement. In contrast, strategies focused on modulating peripheral triggering and central perception are mechanistically viable and clinically meaningful. However, outcome data from these treatment options are limited. Future research needs to focus on understanding mechanisms underlying visceral hypersensitivity and hypervigilance so that appropriate targets and therapies can be developed.

Original languageEnglish
Pages (from-to)1368-1379
Number of pages12
JournalGastroenterology
Volume150
Issue number6
DOIs
StatePublished - May 1 2016

Keywords

  • Chest Pain
  • Dysphagia
  • Esophageal Motility Disorders
  • Gastroesophageal Reflux Disease
  • Globus
  • Heartburn
  • Rome IV

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    Aziz, Q., Fass, R., Gyawali, C. P., Miwa, H., Pandolfino, J. E., & Zerbib, F. (2016). Esophageal disorders. Gastroenterology, 150(6), 1368-1379. https://doi.org/10.1053/j.gastro.2016.02.012