Impaired esophageal motor function in eosinophilic esophagitis

Santander, Cecilio; Chavarría, Carlos; Becerro-González, Irene; Burgos‐Santamaría, Diego

doi:10.17235/reed.2015.3801/2015

Cited by 16 publications

(11 citation statements)

References 44 publications

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“…Although the delayed esophageal clearance was most likely related to the distal esophageal papillomas, it is known that motility deficits can lead to food impaction in eosinophilic esophagitis[ 12 ]. This can lead to serious complications such as perforation.…”

Section: Discussionmentioning

confidence: 99%

Esophageal squamous papillomas with focal dermal hypoplasia and eosinophilic esophagitis

Pasman¹,

Heifert²,

Nylund³

2017

WJG

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Focal dermal hypoplasia (FDH) is a rare disorder of the mesodermal and ectodermal tissues. Here we present an eight-year-old female known to have FDH who presents with poor weight gain and dysphagia. She was diagnosed with multiple esophageal papillomas and eosinophilic esophagitis. She was successfully treated with argon plasma coagulation and ingested fluticasone propionate, which has not been described previously in a child.

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Section: Discussionmentioning

confidence: 99%

Esophageal squamous papillomas with focal dermal hypoplasia and eosinophilic esophagitis

Pasman¹,

Heifert²,

Nylund³

2017

WJG

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“…In 4 cases, they observed simultaneous low-amplitude waves that accounted for not more than 20 % of the manometric tracing. Hence HREM has been established and been considered to be neither necessary nor indicated to establish a diagnosis of EoE, panesophageal pressurization and a history of endoscopic disimpaction has been reported as the predominant association between EoE and esophageal motility disorders [5]. Our patient clearly showed EA type 2 as measured by HREM.…”

Section: Discussionmentioning

confidence: 66%

Eosinophilic esophagitis and achalasia – just a coincidence?

et al. 2019

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Background Eosinophilic esophagitis (EoE) is detected frequently in dysphagia and noncardiac chest pain. Management of patients with EoE may be complicated because EoE is associated frequently with esophageal motility disorders. We present the rare case of esophageal achalasia (EA) associated with eosinophilic infiltration and a literature review. Material and methods A patient with dysphagia and eosinophilic infiltration referred to our clinic underwent standardized diagnostic work-up including symptom questionnaire, esophagogastroduodenoscopy (EGD) with esophageal biopsies, barium swallow, high-resolution esophageal manometry, and combined intraluminal 24-hour pH-impedance testing (pH/MII). Results The patient had an Eckardt score of 8. EGD and mucosal biopsies showed typical EoE with > 15 eosinophil leucocytes per high-power field. Barium swallow revealed typical sign of achalasia. HREM indicated EA type 2 according to the Chicago classification. PH/MII was normal. Oral and systemic corticoid therapy were without effect. After successful treatment by pneumatic dilation of the cardia, symptoms relieved and eosinophilic infiltration returned to normal. Conclusion The results suggest that the patient had primary EA associated with eosinophilic infiltration and that the combined occurrence of these rare diseases is not just a coincidence.

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“…However, high-resolution manometry (HRM) studies of EoE patients indicate esophageal motility abnormalities in 25-76% of patients, suggesting muscle involvement. [29][30][31][32][33][34][35] In support of this possibility, analysis of rare EoE esophagectomy specimens has found evidence of transmural eosinophilic infiltration. 36,37 Additionally, there is one case report describing a patient with achalasia and concomitant EoE who responded to high-dose systemic steroids with resolution of symptoms and manometric abnormalities.…”

Section: Can Eosinophilic Esophagitis Also Cause Achalasia?mentioning

confidence: 94%

Achalasia: physiology and diagnosis

Rieder

Fernandez‐Becker

Sarosiek

et al. 2020

Annals of the New York Academy of Sciences

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Achalasia is a rare motility disorder with incomplete relaxation of the lower esophageal sphincter and ineffective contractions of the esophageal body. It has been hypothesized that achalasia does not result from only one pathway but rather involves a combination of infectious, autoimmune, and familial etiological components. On the basis of other observations, a novel hypothesis suggests that a muscular form of eosinophilic esophagitis is involved in the pathophysiology of achalasia in some patients. This appears to progressively diminish the myenteric plexus at stage III, gradually destroy it at stage II, and finally eliminate it at stage I, the most advanced and final stage of achalasia. Although high-resolution manometry has identified these three different types of achalasia, another subset of patients with a normal-appearing sphincter relaxation has been proposed. Provocative maneuvers, such as the rapid drinking challenge, have recently been demonstrated to improve diagnosis in certain borderline patients, but have to be studied in more detail. However, whether the different types of achalasia will have a long-term impact on tailored therapies is still a matter of debate. Additionally, novel aspects of the standard timed barium swallow appear to be an important adjunct of diagnosis, as it has been shown to have a diagnostic as well as a predictive value.

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Impaired esophageal motor function in eosinophilic esophagitis

Cited by 16 publications

References 44 publications

Esophageal squamous papillomas with focal dermal hypoplasia and eosinophilic esophagitis

Esophageal squamous papillomas with focal dermal hypoplasia and eosinophilic esophagitis

Eosinophilic esophagitis and achalasia – just a coincidence?

Achalasia: physiology and diagnosis

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