Gut Instincts: A Clinician's Handbook of Digestive and Liver Diseases

Eric Esrailian, MD, MPH

Chapter 4: Motility Disorders Of The Upper Gastrointestinal Tract (continued)

Jeffrey L. Conklin, MD, FACG

The hallmark feature of disordered esophageal motor function is dysphagia sensed as food sticking at the suprasternal notch or substernally. Where it is sensed does not predict the location of the obstruction. Esophageal dysphagia is often sensed a few seconds after initiating the swallow. The disease processes that cause esophageal dysphagia and disordered esophageal function are detailed in Table 4-1. Painful swallowing (odynophagia) usually indicates a prominent inflammatory process like an esophageal ulcer. High-resolution esophageal pressure topographic manometry (HREPT) has allowed for…