Overlap Between Gastric and Esophageal Motility Disorders: A Contractual Arrangement?

Excerpt

Disorders of gut–brain interaction [DGBI, also termed functional gastrointestinal (GI) disorders (FGIDs)] and motility disorders are two common GI conditions in which there is no endoscopic evidence of mucosal disease [1]. Whereas the diagnosis of DGBI is currently based on the Rome IV criteria [1], motility disorders are diagnosed with physiological tests including manometry and scintigraphy. The Chicago classification, which is based on high-resolution manometry (HRM), is applied to diagnose esophageal motility disorders that based on new definitions include achalasia, distal esophageal spasm (DES), esophagogastric junction outflow obstruction (EGJOO), ‘jackhammer’ esophagus, absent peristalsis, ineffective esophageal motility (IEM), and fragmented peristalsis [2]. In the stomach, motility disorders are categorized based on a standardized radiographic measure, 4-h gastric emptying scintigraphy (GES). More than 60 and 10% retention of the solid egg-based radiolabeled meal at 2 and 4 h, respectively, is considered evidence of gastroparesis (GP), whereas < 35% retention at 1 h and < 20% at 2 h suggest rapid emptying or dumping syndrome [3]. …