Functional Diseases of the Esophagus: Role of Endoscopy

Author:

Swamy Nanjunda1,Rayl John E.1

Affiliation:

1. Lake City, Florida

Abstract

The use of endoscopic procedures in the evaluation of primary motor disorders, or functional diseases, of the esophagus is filled with both risks and benefits. Since both flexible and open-tube esophagoscopy carry a significant risk factor, it is necessary to have a clear concept of the indications and value of endoscopy in the management of functional diseases of the esophagus. A review of the literature reveals very little documentation on the value of endoscopy in diagnosing esophageal functional diseases other than Zenker's diverticulum and achalasia. Based on the current literature and the experience of the authors, observations and recommendations concerning the role of endoscopy in functional diseases of the esophagus are presented. These are: 1) In Phase I or upper esophageal sphincter dysfunctions, endoscopy contributes little to their understanding, is difficult to perform, and may be hazardous. In this group, esophagoscopy should be reserved for indications beyond the dysfunction itself. If endoscopy has to be performed, open-tube esophagoscopy should be performed by an experienced endoscopist. 2) In functional diseases of the esophageal body or Phase II dysfunction, endoscopy is frequently valuable. In spastic disorders, it helps to differentiate between primary spasm of neuromuscular origin and spasm secondary to esophagitis or an obstructive process. In scleroderma and pulsion diverticulum, endoscopy helps to identify such unsuspected complications as esophagitis, hiatal hernia, and carcinoma. 3) In Phase III or lower esophageal sphincter dysfunctions, endoscopic examination is essential both to rule out organic lesions that simulate functional disorders, and to determine the presence and extent of esophagitis.

Publisher

SAGE Publications

Subject

General Medicine,Otorhinolaryngology

Reference12 articles.

1. Instrumental Perforations of the Esophagus

2. Spiro HM: Clinical Gastroenterology, ed 2. New York, Macmillan, 1977, pp 42–66.

3. Earlam R: Clinical Tests of Oesophageal Function. New York, Grune and Stratton, 1976, p 73.

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1. Rigid endoscopy in globus pharyngeus: how valuable is it?;The Journal of Laryngology & Otology;2005-11-25

2. Rigid endoscopy in ENT practice;The Journal of Laryngology & Otology;1987-03

3. Role of Esophagoscopy in the Evaluation of Patients with Head and Neck Carcinoma;Annals of Otology, Rhinology & Laryngology;1983-07

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