ELEAZAR D.

RAMILLANO

DEFINITION
Is absent or ineffective peristalsis of the distal esophagus, accompanied by failure of the esophageal sphincter to relax in response to swallowing . Narrowing of the esophagus just above the stomach result in gradually increasing dilation of the of the esophagus in the upper chest . - may progress slowly and occur most often in people 40 years of age or older.

Assessment and Diagnostic Findings

X-ray studies show esophageal dilation above the narrowing at the gastro esophageal junction. Barium swallow, computed tomography (CT) of the chest and endoscopy may be used for diagnosis; however, manometry, a process in which the esophageal pressure is measured by a radiologist or gastroenterologist, confirms the dsiagnosis.

Management
The patient is instructed to eat slowly and drink fluids with meals. Calcium channel blockers and nitrates have been used to decrease esophageal pressure and improve swallowing. Injection of botulinum toxin (botox) into quadrants of the esophagus via endoscopy has been helpful because it inhibits the contraction of the smooth

Management

May be treated conservatively by pneumatic dilation to stretch the narrowed area of the esophagus