Therapieoptionen von primären Motilitätsstörungen des Ösophagus

Ulrike Denzer; Michaela Müller; Nicole Kreuser; René Thieme; Albrecht Hoffmeister; Juergen Feisthammel; Stefan Niebisch; Ines Gockel

doi:10.1055/a-1949-3583

Laryngo-Rhino-Otologie, Table of Contents

Laryngorhinootologie 2023; 102(11): 824-838
DOI: 10.1055/a-1949-3583

Übersicht

Therapieoptionen von primären Motilitätsstörungen des Ösophagus

Therapy of esophageal motility disorders

Authors

Ulrike Denzer

¹Gastroenterologie, Endokrinologie, Stoffwechsel und klinische Infektiologie, Universitätsklinikum Gießen und Marburg - Standort Marburg, Marburg, Germany (Ringgold ID: RIN61061)
Michaela Müller

²Klinik und Poliklinik für Gastroenterologie, Endokrinologie, Stoffwechsel und klinische Infektiologie, Universitätsklinikum Gießen und Marburg, Marburg, Germany
Nicole Kreuser

³Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitatsklinikum Leipzig, Leipzig, Germany (Ringgold ID: RIN39066)
René Thieme

³Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitatsklinikum Leipzig, Leipzig, Germany (Ringgold ID: RIN39066)
Albrecht Hoffmeister

³Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitatsklinikum Leipzig, Leipzig, Germany (Ringgold ID: RIN39066)
Juergen Feisthammel

³Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitatsklinikum Leipzig, Leipzig, Germany (Ringgold ID: RIN39066)
Stefan Niebisch

³Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitatsklinikum Leipzig, Leipzig, Germany (Ringgold ID: RIN39066)
Ines Gockel

³Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitatsklinikum Leipzig, Leipzig, Germany (Ringgold ID: RIN39066)

Abstract

Zusammenfassung

Ösophagusmotilitätsstörungen sind Erkrankungen, bei denen es aufgrund einer Veränderung der neuromuskulären Strukturen zu Fehlfunktionen des Schluckakts kommt. Das Leitsymptom ist daher die Dysphagie für feste und/oder flüssige Speisen, häufig begleitet von Symptomen wie Thoraxschmerz, Regurgitation, Sodbrennen, und Gewichtsverlust. Die Ösophagusmanometrie ist der Goldstandard in der Diagnostik. Endoskopie und Radiologie dienen dem Ausschluss entzündlicher oder maligner Veränderungen.

Durch die Einführung der hochauflösenden Ösophagusmanometrie (HRM) hat sich die Diagnostik der Ösophagusmotilitätsstörungen verbessert und mit der Chicago-Klassifikation zu einer neuen Einteilung geführt, die im letzten Jahrzehnt mehrfach modifiziert wurde, zuletzt 2020 mit der Chicago-Klassifikation v4.0. Verglichen mit der Vorversion v3.0 finden sich einige wichtige Änderungen, die anhand der im klinischen Alltag wichtigsten Ösophagusmotilitätsstörungen vorgestellt werden.

Abstract

Esophageal motility disorders are diseases in which there are malfunctions of the act of swallowing due to a change in neuromuscular structures. The main symptom is therefore dysphagia for solid and/or liquid foods, often accompanied by symptoms such as chest pain, regurgitation, heartburn, and weight loss. Esophageal manometry is the gold standard in diagnostics. Endoscopy and radiology serve to exclude inflammatory or malignant changes. With the introduction of high-resolution esophageal manometry (HRM), the diagnosis of esophageal motility disorders has improved and led to a new classification with the Chicago Classification, which has been modified several times in the last decade, most recently in 2020 with the Chicago Classification v4.0. Compared to the previous version 3.0, there are some important changes that are presented based on the most important esophageal motility disorders in everyday clinical practice.

Schlüsselwörter

Evidenz Typ I-Studien - Achalasie - Motilitätsstörungen des Ösophagus - endoskopisch-interventionelle Therapie - Heller Myotomie

Keywords

Evidence type I-studies - achalasia - motility disorders of the esophagus - endoscopic-interventional therapy - Heller Myotomy

Full Text

References

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