Achalasia other diagnostic studies: Difference between revisions

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Revision as of 18:46, 5 September 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Other Diagnostic Studies

Manometry

Manometry, the key test for establishing the diagnosis. A probe measures the pressure waves in different parts of the esophagus and stomach during the act of swallowing. A thin tube is inserted through the nose, and the patient is instructed to swallow several times.

Elevated resting LES pressure, usually > 45 mmHg.
Incomplete relaxation of the LES.
Aperistalsis – contractions may be absent, diffuse and not coordinated, and / or ‘vigorous’ (> 60 mmHg).

Cholecystokinin (CCK) stimulation test

Cholecystokinin (CCK) stimulation test: CCK causes mild contraction of the LES and a more pronounced release of inhibitory neurotransmitters in the wall of the esophagus. In normal people, LES tone will decrease due to the predominant effect of the inhibitory neurotransmitters. In patients with achalasia, however, the stimulatory effect on the LES is unopposed, and LES pressure increases.

Endoscopy

Endoscopy, which provides a view inside the esophagus and stomach. A small camera is inserted through the mouth while the patient is under sedation. The endoscopist observes a "pop" as the scope passes through the non-relaxing lower esophageal sphincter.

@@ Line 7: / Line 7: @@
 ==Other Diagnostic Studies==
-*'''[[Manometry]]''', the key test for establishing the diagnosis. A probe measures the pressure waves in different parts of the esophagus and stomach during the act of swallowing. A thin tube is inserted through the nose, and the patient is instructed to swallow several times.
-*:* Elevated resting LES pressure, usually > 45 mmHg.
+===Manometry===
-*:* Incomplete relaxation of the LES.
+[[Manometry]], the key test for establishing the diagnosis. A probe measures the pressure waves in different parts of the esophagus and stomach during the act of swallowing. A thin tube is inserted through the nose, and the patient is instructed to swallow several times.
-*:* Aperistalsis – contractions may be absent, diffuse and not coordinated, and / or ‘vigorous’ (> 60 mmHg).
+* Elevated resting LES pressure, usually > 45 mmHg.
-* '''Cholecystokinin''' (CCK) stimulation test: CCK causes mild contraction of the LES and a more pronounced release of inhibitory neurotransmitters in the wall of the esophagus.  In normal people, LES tone will decrease due to the predominant effect of the inhibitory neurotransmitters.  In patients with achalasia, however, the stimulatory effect on the LES is unopposed, and LES pressure increases.
+* Incomplete relaxation of the LES.
-*'''[[Endoscopy]]''', which provides a view inside the esophagus and stomach. A small camera is inserted through the mouth while the patient is under sedation.  The endoscopist observes a "pop" as the scope passes through the non-relaxing [[lower esophageal sphincter]].
+* Aperistalsis – contractions may be absent, diffuse and not coordinated, and / or ‘vigorous’ (> 60 mmHg).
+===Cholecystokinin (CCK) stimulation test===
+Cholecystokinin (CCK) stimulation test: CCK causes mild contraction of the LES and a more pronounced release of inhibitory neurotransmitters in the wall of the esophagus.  In normal people, LES tone will decrease due to the predominant effect of the inhibitory neurotransmitters.  In patients with achalasia, however, the stimulatory effect on the LES is unopposed, and LES pressure increases.
+===Endoscopy===
+[[Endoscopy]], which provides a view inside the esophagus and stomach. A small camera is inserted through the mouth while the patient is under sedation.  The endoscopist observes a "pop" as the scope passes through the non-relaxing [[lower esophageal sphincter]].
 ==References==
 {{Reflist|2}}