Esophageal Dysmotility

Abstract

The normal esophageal swallow is a complex process requiring coordinated autonomic innervation, complex contractions of striated and smooth muscle, and appropriately timed relaxation at the lower esophageal sphincter (LES) to deliver a bolus to the stomach (Fu et al. Non-neoplastic disorders of the esophagus). Impairment of any aspect in that process can result in esophageal dysmotility, a group of disorders characterized by abnormal peristalsis of the esophageal body or impaired relaxation at the LES. Esophageal dysmotility can occur both primarily and secondarily as a feature in other disorders, and its effects can be debilitating. Appropriate management of esophageal dysmotility hinges on accurate assessment, best accomplished by a multidisciplinary team with careful history and utilization of both functional imaging as well as high-resolution manometry (HRM). Treatment ranges from conservative approaches such as dietary modification to surgical intervention including Heller myotomy. An understanding of esophageal dysmotility is important for those caring for children with dysphagia.