[Gastrointestinal motility disorders relevant to general practice].
Gastroesophageal reflux disease, achalasia and esophageal spasms are the most frequent esophageal motility disorders and are associated with dysphagia and non-cardiac chest pain. The diagnosis of achalasia is based on manometric criteria. Pneumatic dilatation, laparoscopic myotomy, and the minimal invasive injection of botulinum toxin are therapeutic options. Long-term-pH-metry is the gold standard to diagnose gastroesophageal reflux disease. Proton pump inhibitors (PPI) are the first-line therapy in reflux disease. Esophageal manometry and pH-metry are essential investigations prior to an antireflux operation. The evaluation of chronic constipation refractory to medical treatment should include anal manometry, and MR-defecography for the diagnosis of anorectal outlet obstruction such as anismus which could be treated successfully by biofeedback therapy.
Thumshirn
M
M
Departement Innere Medizin, Abteilung für Gastroenterologie und Hepatologie, Universitätsspital Zürich.
D002908:Chronic Disease; D003248:Constipation / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005194:Family Practice; D006801:Humans