NUT CRACKER OESOPHAGUS

• Motility disorder includes-

i) Achalasia cardia

ii) Diffuse oesophageal spasm

iii) Nut cracker oesophagus

iv) Hypertensive LES

 

• Nut Cracker Oesophagus is a hypermotility disorder with high amplitude peristalsis.
• Waves of hypertensive amplitude pressure >180 mm Hg.
• Long duration contraction waves >6sec with normal LES pressure and LES relaxation.

  

CLINICAL FEATURES-

• Equal in both sexes
• Severe chest pain, dysphagia without regurgitation
• Odynophagia
• MC and most painful oesophageal hypermotility disorder.

 

INVESTIGATION-

• Manometry

 

TREATMENT-

• Dilatation
• Myotomy
• PPI
• Calcium channel blockers
• Antispasmodics

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