Jackhammer esophagus: Observations on a European cohort

Abstract

The symptom dysphagia is accompanied with strong contractions of the LES, signs of a possible outflow obstruction, and a very high DCI. The presence of a multipeaked contraction seems to be of limited relevance, and caution is warranted in labeling patients with one hypercontractile swallow as normal.

Jackhammer esophagus: Assessing the balance between prepeak and postpeak contractile integral

“…A recent publication by Bredenood et al. confirmed that the chest pain in Jackhammer esophagus was not related to the value of DCI, however, dysphagia did show a correlation with DCI and an elevated intrabolus pressure . In our study, the parameters evaluated among the first five intact swallows and the swallow with the maximal DCI revealed higher POSP‐CI‐tc/PREP‐CI‐tc in patients with IDQ ≥ 6 than those ≤6.…”

Dysphagia severity is related to the amplitude of distal contractile integral in patients with Jackhammer esophagus

“…Importantly, Herregods et al. first revealed a trend towards an association between dysphagia and the DCI in HRM, that reached a significant level when only hypercontractile swallows were analysed . Moreover, they reported that patients had dysphagia when contractions of the LES zone exceeded 2000 mm Hg/s/cm.…”

“…Interestingly, pathophysiological factors causing this new entity are still a matter of debate. Hypercontractility may be present as primary motility disorder but was also registered in the context of outflow obstruction and gastroesophageal reflux disease (GERD) . Furthermore, researchers emphasized the co‐incidence of symptoms like dysphagia and non‐cardiac chest pain in these patients.…”

High-resolution esophageal manometry

“…6 Though hypercontractile swallows manifest as single- or multi-peaked contractions, the clinical relevance of these contraction types is unclear. 22 …”