Dyskinesia of the esophagus in children: causes, symptoms, diagnosis, treatment

Dyskinesia of the esophagus - violation of esophagus motility in the absence of gastroesophageal reflux and signs of inflammation of the mucous membrane.

The code on МКВ-10

K22.4. Dyskinesia of the esophagus.

Classification of esophagus dyskinesia

• Violation of the peristalsis of the thoracic esophagus:
  • hypermotor dyskinesia (segmental esophagospasm - the "esophagus of the nutcracker", diffuse esophagospasm, nonspecific motor disorders);
  • hypomotor dyskinesias.
• Disturbance of the sphincter of the esophagus:
  • lower (failure of the cardia - gastroesophageal reflux, cardiospasm);
  • the upper.

Causes and pathogenesis of esophagus dyskinesia

Isolate primary and secondary dyskinesia of the esophagus. Presumably, the pathogenesis of primary dyskinesia is caused by changes in the nervous and humoral regulation of the esophagus, and secondary diseases are considered symptoms of diseases of the esophagus, other organs and systems.

Symptoms of esophagus dyskinesia

Hypermotor dyskinesia of the esophagus is characterized by chest pains, sensation of a lump in the throat, which often occurs with neuroses and hysteria due to spasm of the primary esophagus. Dysphagia (in 90% of patients) is unstable, paradoxical (difficulty in passing through liquid food with normal swallowing thick), with increased symptoms from too hot or cold food, as well as with psychoemotional stress. At an early age, attacks of apnea, bradycardia, and periodic regurgitation are possible.

In the case of hypomotor dyskinesia, dysphagia develops, a feeling of heaviness in the epigastric region after eating, aspiration of food with the development of chronic bronchitis and pneumonia, an endoscopic picture of esophagitis, a decrease in pressure in the lower esophageal sphincter.

If the activity of the upper sphincter of the esophagus is disturbed, swallowing is difficult due to a weakening of the sphincter and esophageal-pharyngeal reflex; with the defeat of the lower - cardiospasm with a bright psychosomatic picture, a constant sensation of a lump in the throat, quickening of the breath and complaints of lack of air, food dips, burning sensation and chest pain, heartburn, belching and food eaten.

Diagnosis of esophagus dyskinesia

Endoscopically the mucosa of the esophagus looks normal, with fluoroscopy you can detect spasms. The diagnosis is established based on the data obtained with esophagus manometry.

Differential diagnostics

Dyskinesia of the esophagus is differentiated with anomalies in the development of the esophagus and major vessels, gastroesophageal reflux disease.

Treatment of esophageal dyskinesia

Treatment of dyskinesia of the esophagus includes the elimination of psychotraumatic situations, a diet with the exception of acute, cold and very hot food, as well as medicinal spasmolytic therapy (slow calcium channel blockers, nitrates, see above). Published data on the effectiveness of antidepressants, psychotherapy.

[1], [2], [3], [4], [5]