Onigiri esophagography as a screening test for esophageal motility disorders

Hamada, Shohei; Ihara, Eikichi; Muta, Kazumasa; Wada, Masafumi; Hata, Yoshitaka; Ikeda, Hiroko; Tanaka, Yoshimasa; Ogino, Hitoshi; Chinen, Takatoshi; Ogawa, Yoshihiro

doi:10.5056/jnm20138

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…Moreover, a liquid barium swallowing test cannot assess luminal distensibility, which is relevant, particularly in patients with disorders of EGJ outflow. Barium swallow using “Onigiri,” a Japanese rice ball, may enable the evaluation of distensibility, thereby increasing diagnostic yield [11].…”

Section: Diagnosismentioning

confidence: 99%

Esophageal Motility Disorders: Diagnosis and Treatment Strategies

Hoshikawa,

Iwakiri

2023

Digestion

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Background: Esophageal motility disorders (EMDs) are caused by the impaired relaxation of the upper/lower esophageal sphincter and/or defective esophageal peristaltic contractions, resulting in dysphagia and noncardiac chest pain. High-resolution manometry (HRM) is essential for the diagnosis of primary EMD; however, the recognition of EMD and HRM by general practitioners in Japan is limited. This review summarizes the diagnosis of and treatment strategies for EMD. Summary: HRM is a specific test for the diagnosis of EMD, whereas endoscopy and barium swallow as screening tests provide characteristic findings (i.e., esophageal rosette and bird’s beak sign) in some cases. It is important to note that manometric diagnoses apart from achalasia are often clinically irrelevant; therefore, the recently updated guidelines suggest additional manometric maneuvers, such as the rapid drink challenge, and further testing, including functional lumen imaging, for a more accurate diagnosis before invasive treatment. Endoscopic/surgical myotomy, pneumatic dilation, and botulinum toxin injections need to be considered for patients with achalasia and clinically relevant esophagogastric junction outflow obstruction. Key Message: Since the detailed pathophysiology of EMD remains unclear, their diagnosis needs to be cautiously established prior to the initiation of invasive treatment.

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Section: Diagnosismentioning

confidence: 99%