Opioid-induced functional esophagogastric junction obstruction

Saéz-González, Esteban; Díaz-Jaime, Francia Carolina; García-Morales, Natalia; Herreras-López, Julia; Ortiz, Vicente; Ortuño, Juan; Garrigues, Vicente

doi:10.1016/j.gastre.2017.03.001

Cited by 1 publication

(2 citation statements)

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“…56,57 Ratuapli and colleagues showed that in a cohort of 121 patients investigated for oesophageal symptoms, the incidence of type III achalasia and idiopathic GOJ outflow obstruction was higher in patients taking opiates, and in many, this can be reversible when opiates are terminated. [56][57][58] Hypercontractile disorders as defined by the Chicago Classification can be a cause of NCCP. 49 However, hypertensive peristaltic contractions can also sometimes be seen in asymptomatic individuals, so the relationship between symptoms and hypercontractility is not always straightforward, especially if symptoms are not reproduced during testing.…”

Section: Oesophageal Dysmotilitymentioning

confidence: 99%

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The role of oesophageal physiological testing in the assessment of noncardiac chest pain

Heinrich

Sweis

2018

Therapeutic Advances in Chronic Disease

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Oesophageal physiology testing plays an important role in the diagnosis of noncardiac chest pain (NCCP) after cardiac, structural and mucosal abnormalities have been ruled out. Endoscopy can establish the presence of structural causes of chest pain such as cancer, oesophageal webs and diverticula. Even if macroscopically normal, eosinophilic oesophagitis is a common cause of chest pain and needs to be ruled out with an adequate biopsy regimen. In the remaining cases, diagnosis is focused on the identification of often subtle mechanisms that lead to NCCP. The most common oesophageal aetiologies for NCCP are gastro-oesophageal reflux disease (GORD), oesophageal dysmotility and functional chest pain. Ambulatory pH studies (with or without impedance or wireless measurements) can establish the presence of GORD, nonerosive reflux as well any association with symptoms of chest pain. High-resolution manometry, particularly with the inclusion of adjunctive testing, can rule out major motility disorders such as spasm, hypercontraction or achalasia. The EndoFLIP device can help define disorders with reduced distensibility, not easily appreciated with endoscopy or manometry. When all tests remain negative, a diagnosis of oesophageal hypersensitivity is normally made and therapy is shifted from targeting a disease to treating symptoms and patient affect.

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