A High-resolution View of Achalasia

Jee, Sam-Ryong; Pimentel, Mark; Soffer, Edy E.; Conklin, Jeffrey L.

doi:10.1097/mcg.0b013e318176ab94

Cited by 11 publications

(7 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings are also similar to previous adult studies (21). Finally, recent studies with HRM in adults have also demonstrated that some degree of true LES relaxation, although impaired, does exist in patients with achalasia with minimal axial displacement (17,31,32). These results support that the finding of some degree of LES relaxation in conventional manometry is a true phenomenon.…”

Section: Discussionsupporting

confidence: 93%

Heterogeneity of Lower Esophageal Sphincter Function in Children With Achalasia

Morera¹,

Nurko²

2012

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 93%

Heterogeneity of Lower Esophageal Sphincter Function in Children With Achalasia

Morera¹,

Nurko²

2012

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

show abstract

“…Zhang and Diamant observed spontaneous rhythmic contractions in patients with achalasia (Zhang and Diamant, 1994) although this was not observed in another comprehensive study where rhythmic activity was only seen to be swallow-induced (Jee et al, 2009). In recent years, achalasia is classified according to high-resolution manometry features.…”

Section: Discussionmentioning

confidence: 95%

“…Jee et al suggested that they originated in the upper esophageal sphincter (UES) since there they had the highest amplitude (Jee et al, 2009). Zhang and Diamant noted that rhythmic esophageal contractions were not common when the UES did not show them (Zhang and Diamant, 1994).…”

Section: Discussionmentioning

confidence: 99%

On the origin of rhythmic contractile activity of the esophagus in early achalasia, a clinical case study

et al. 2013

View full text Add to dashboard Cite

A patient with early achalasia presented spontaneous strong rhythmic non-propulsive contractions at ~7/min, independent of swallows. Our aim was to evaluate characteristics of the rhythmic contractions, provide data on the structure of pacemaker cells in the esophagus and discuss a potential role for interstitial cells of Cajal (ICC) in the origin of rhythmicity. We hypothesize that intramuscular ICC (ICC-IM) are the primary pacemaker cells. The frequency but not the amplitude of the rhythmic contractions was inhibited by the phosphodiesterase inhibitor drotaverine consistent with cAMP inhibiting pacemaker currents in ICC-IM. The frequency increased by wet swallows but not dry swallows, consistent with stretch causing increase in slow wave frequency in ICC-IM. New studies on archival material showed that ICC-IM were present throughout the human esophageal musculature and were not diminished in early achalasia. Although ICC-IM exhibited a low density, they were connected to PDGFRα-positive fibroblast-like cells with whom they formed a dense gap junction coupled network. Nitrergic innervation of ICC was strongly diminished in early achalasia because of the loss of nitrergic nerves. It therefore appears possibly that ICC-IM function as pacemaker cells in the esophagus and that the network of ICC and PDGFRα-positive cells allows for coupling and propagation of the pacemaker activity. Loss of nitrergic innervation to ICC in achalasia may render them more excitable such that its pacemaker activity is more easily expressed. Loss of propagation in achalasia may be due to loss of contraction-induced aboral nitrergic inhibition.

show abstract

“…The incidence and prevalence of achalasia have been recently reported to be 1.63/100 000 and 10.82/100 000 in Western countries . HRM is a precise tool for the assessment of esophageal motility disorders including achalasia . As a newly introduced manometric method, to date, limited information about the HRM parameters of normal individuals or esophageal motility disorder is available in China.…”

Section: Discussionmentioning

confidence: 99%