Esophageal Motility Disorders: Types, Symptoms, Treatment, Recovery, Risk Factors, Complications
The esophagus is an 8 inch long muscular hollow tube which connects the throat to the stomach. It is also known as food pipe. When at rest, esophagus is closed. To keep food from coming back to the mouth from the stomach, it has two circular rings. The one at the top is known as upper esophagus sphincter and the one at the bottom is known as lower esophagus sphincter. When a person drinks and eats something, the body’s nervous system detects this and brain opens the upper esophagus sphincter and thus allowing food to pass in the stomach through this food pipe. However, if the muscles in your esophagus have not swallowed the food properly, it will be harder for the food to reach the stomach and this condition is known as esophageal motility disorder. It becomes difficult to swallow the food properly, and thus food reflux happens and can sometimes cause acidity, constipation, dehydration, sore throat, and chest pain.
Types of Esophageal Motility Disorders
The different types of esophageal motility disorders are:
Eosinophilic Esophagitis: Eosinophilic esophagitis is an inflammatory disorder in which the wall of the esophagus becomes filled with too many eosinophils, a type of white blood cells. This type of esophageal motility disorders may be caused by food allergies. Especially, in children, it makes eating and drinking a difficult task and the child experienced chest pain, vomiting or both. People may have allergic disorders like asthma or eczema.
Gastroesophageal Reflux Disorder: Gastroesophageal reflux disorder is a very common type of esophageal motility disorders. It occurs in 1 to 30% of the adults. This condition is caused when the lower esophageal sphincter is not functioning properly. As mentioned above, the main function of lower esophageal sphincter is to close the bottom of the esophagus so that food and stomach acid do not come back in the esophagus. Reflux is also more likely to occur after meals when the volume of acid in the stomach is higher and sphincter fails to work properly and causes gastroesophageal reflux disorder.
Dysphagia Lusoria: Dysphagia means ineffective swallowing. Dysphagia Lusoria is the birth defect, which makes it difficult for a child to swallow in food and drinks. Sometimes, it occurs when the muscles and tongue that push the food to esophagus are not working properly because of a stroke or disease affecting the muscles or nerves.
Achalasia: Achalasia is a another type of esophageal motility disorders in which the lower esophageal sphincter doesn’t relax properly and can cause the part of the esophagus above it to enlarge greatly. This enlargement contributes to too many symptoms like chest pain, difficulty in swallowing, vomiting and uneasiness. Sometimes individuals experience chest pain which is not heartburn and that may also be confused with the pain of heart. So, if your age is 50 or more, your doctor will first check your cardiac health; but, in many cases your heart is healthy and what makes you feel the chest pain is achalasia.
Symptoms of Esophageal Motility Disorder
Sign and Symptoms of esophageal motility disorder include:
Sign and Symptoms of Esophageal Motility Disorder in Adults:
- Difficulty squeezing
- Food getting stuck in the esophagus
- Chest pain after eating food
- Abdominal pain
- Acid reflux
- Vomiting and constipation
- A sore throat
- Decrease in appetite
- Muscle ache and fever.
Sign and Symptoms of Esophageal Motility Disorder in Children:
- Difficulty in eating and feeding
- Abdominal pain
- No response to gastroesophageal reflux disorder medication
- Poor growth, malnutrition, and weight loss
- Pain while swallowing.
Risk Factors for Esophageal Motility Disorder
Risk Factors are associated with esophageal motility disorders are:
Atmosphere: Individuals who live in a cool or dry atmosphere are more probable than those in different atmospheres to be diagnosed with esophageal motility disorder or eosinophilic esophagitis.
Season: Esophageal motility disorder is more probable between the spring and fall. The reason behind could be the increased levels of dust and different allergens and also since individuals are more prone to be outside during this time.
Age: Initially, eosinophilic esophagitis was believed to be a childhood infection. However, an increasing number of adults are diagnosed with it in the recent days.
Sex: Eosinophilic esophagitis is more typical in men than in females.
Family History of Esophageal Motility Disorder: According to experts, esophageal motility disorder runs in the family. If any of your family members has eosinophilic esophagitis, you have a higher risk of getting diagnosed with it too.
Hypersensitivities and Asthma: If you have food or environmental allergies, asthma, atopic dermatitis or a chronic respiratory illness, your risk of getting diagnosed with esophageal motility disorder is high.
Treatment for Esophageal Motility Disorder
There are few treatment options for relieving the symptoms of esophageal motility disorder and they are:
Diet Changes to Treat Esophageal Motility Disorder: Diet is one of the most effective treatments for esophageal motility disorder in children and adults. Esophageal motility disorder could be caused and made worse by eating foods that one is allergic to, your treatment may include avoiding that food. As food allergy reactions often take three to four days to react, so it is very difficult to find which food you ate a few days ago that’s now causing an allergic response. In the diet routine, all foods that you ate a few days ago are completely removed from your diet, and then slowly re-introduced one by one to determine if you are sensitive to any of them.
Esophageal Dilation: Dilation of esophageal strictures is effective for relieving dysphagia; however, it has no impact on the fundamental inflammation. It is usually done on patients who have not achieved any relief after conventional treatment modalities or medications for esophageal motility disorder.
Botox: Botox injection helps in releasing muscle spasm of the lower esophageal sphincter in a better way as compared to any other treatment modes. Botulinum toxin, a powerful neurotoxin is injected into the lower esophageal sphincter. This treatment for esophageal motility disorder is nearly as powerful as dilation, yet the relief may just last for 6 months to 1 year.
Myotomy: Myotomy is the second treatment choice for esophageal motility disorder. This includes a medical procedure to cut the muscle filaments in the lower esophageal sphincter. The methodology is normally finished with a laparoscope or, less commonly, with a thoracoscope. It can rarely be also done with an endoscope. Myotomy is more effective in more than 85% of the time.
Endoscopy for Esophageal Motility Disorder: It includes the specialist to look down through the patient's mouth into the throat and stomach. An adaptable tube with a small camera is inserted through the mouth, throat and food pipe of the patient and the doctor gets to see the stomach and its nearby structures in a screen due to the pictures taken by the camera. Diseases and areas of inflammation can be revealed, and if the doctor perceives abnormal tissue, it is collected for sending for a biopsy. Patients might be sedated during the treatment.
Medical researchers are still searching for what is the best method to deal with esophageal motility disorder. The current treatments and medication can only control the symptoms but not effectively reduce the discomfort. Because of the risk of tearing with dilation and the risks of discomfort in the surgery, the only method that is recommended by most of the doctors is botulinum toxin because there is a less long-term complication with this treatment.
Complications of Esophageal Motility Disorder
Esophageal motility disorder causes uneasiness for patients; yet it commonly isn’t related to extreme side effects. Sometimes, throat related chest pain leads to emergency room visits due to the fear of heart attack. Esophageal motility disorder caused due to scleroderma or diabetes can bring in a range of increased difficulties related to these conditions.
Recovery from Esophageal Motility Disorder
Individuals with esophageal motility disorder will benefit from the following things during their recovery period:
- Eating smaller meals
- Eating dinner 2-3 hours before bedtime. This allows the food to get digested enough before going to bed to avoid reflux.
- Sleeping on an inclined position with the head of the bed slightly rose.
- In case of obese patients, losing weight and regular exercise is essential.
- Reducing or completely avoiding alcohol intake.
- Seeking psychiatric care, if the patient has a history of anxiety, and depression or any mental health disorder for that matter.
Esophageal motility disorder is a treatable disease. Though, there are lots of complications that patients may experience before and after the treatment but all the discomfort and complications easily heal with time. The individuals suffering from esophageal motility disorder need to follow their doctor’s instruction, do exercise and take liquid diet such as drinking mixed vegetable juice, orange juice, pineapple juice to keep immunity system stronger and it also reduces acid reflux in the body. Make a meeting with your doctor in the event that you encounter intense symptoms of esophageal motility disorder.
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