Nutcracker Ozuphagus
The picture characterized by high amplitude peristaltic contractions (hypertensive esophagus) and precordial pain in the esophagus is defined as nutcracker esophagus.- LES relaxation and pressure are usually normal.
- Patients may experience defecation irregularities, depression and anxiety.
- Calcium channel blockers and antidepressants are used in the treatment. (no place for surgery)
Hypertensive lower esophageal sphincter
It is a motility disorder in which only the lower esophageal sphincter pressure is increased but relaxation is normal. (Other esophageal parts are normal)Scleroderma (systemic sclerosis)
• There is a loss of peristalsis and a decrease in LES pressure in the lower 2/3 segments due to the destruction/fibrosis of the esophageal smooth muscle.• It is characterized by symptoms of GERD with dysphagia.
• Definitive diagnosis is made by manometry.
When amyloidosis involves the esophagus, it can lead to scleroderma-like findings.
The upper 1/3 of the esophagus consists of striated muscle and the lower 2/3 of smooth muscle. For this reason, skeletal muscle diseases such as polymyositis and dermatomyositis are located in the upper part, while diseases such as scleroderma are located in the lower part.