Skip to main content
NCBI home page
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1966 Nov 5;95(19):941–946.

Dyschalasia: A Variant or Early Phase of Achalasia?

A Review of Motor Disturbances in Achalasia with Reference to Late Relaxation of the Lower Esophageal Sphincter

Ivan T Beck, Naomi A Hernandez, Jeno Solymar
PMCID: PMC1935748  PMID: 5922908

Abstract

One of the characteristic motor abnormalities in achalasia of the esophagus is the lack of relaxation of the lower esophageal sphincter during swallowing. In a subject with a clinical history and radiologic evidence of early achalasia all the typical motor abnormalities of the disease were observed in the course of pressure studies, but the sphincter exhibited a fall of pressure in response to a contraction of the body of the esophagus. This relaxation occurred later than would be expected in the normal esophagus and, therefore, this unusual condition was named dyschalasia.

The relationship of dyschalasia to classical achalasia is discussed and several theories are advanced. The authors believe that dyschalasia is possibly an early stage of achalasia.

Full text

PDF
941

Images in this article

945Fig. 7
on p.945
945Fig. 8
on p.945

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BUTIN J. W., OLSEN A. M., MOERSCH H. J., CODE C. F. A study of esophageal pressures in normal persons and patients with cardiospasm. Gastroenterology. 1953 Feb;23(2):278–293. [PubMed] [Google Scholar]
  2. CARVETH S. W., SCHLEGEL J. F., CODE C. F., ELLIS F. H., Jr Esophageal motility after vagotomy, phrenicotomy, myotomv. and mvomectomv in dogs. Surg Gynecol Obstet. 1962 Jan;114:31–42. [PubMed] [Google Scholar]
  3. CASSELLA R. R., BROWN A. L., Jr, SAYRE G. P., ELLIS F. H., Jr ACHALASIA OF THE ESOPHAGUS: PATHOLOGIC AND ETIOLOGIC CONSIDERATIONS. Ann Surg. 1964 Sep;160:474–487. doi: 10.1097/00000658-196409000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. CREAMER B., OLSEN A. M., CODE C. F. The esophageal sphincters in achalasia of the cardia (cardiospasm). Gastroenterology. 1957 Aug;33(2):293–301. [PubMed] [Google Scholar]
  5. CREAMER B., PIERCE J. W. Observations on the gastrooesophageal junction during swallowing and drinking. Lancet. 1957 Dec 28;273(7009):1309–1312. doi: 10.1016/s0140-6736(57)91638-0. [DOI] [PubMed] [Google Scholar]
  6. CROSS F. S. Pathologic changes in megaesophagus (esophageal dystonia). Surgery. 1952 May;31(5):647–653. [PubMed] [Google Scholar]
  7. Dale H. H., Feldberg W. The chemical transmitter of vagus effects to the stomach. J Physiol. 1934 Jun 9;81(3):320–334. doi: 10.1113/jphysiol.1934.sp003138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. EDWARDS D. A., ROWLANDS E. N. Physiological observations in achalasia and their significance in methods of treatment. Gastroenterologia. 1959;92:114–123. doi: 10.1159/000202881. [DOI] [PubMed] [Google Scholar]
  9. Feldberg W., Vogt M. Acetylcholine synthesis in different regions of the central nervous system. J Physiol. 1948 Jun 25;107(3):372–381. doi: 10.1113/jphysiol.1948.sp004282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. HIGHTOWER N. C., Jr Esophageal motility in health and disease. Dis Chest. 1955 Aug;28(2):150–169. doi: 10.1378/chest.28.2.150. [DOI] [PubMed] [Google Scholar]
  11. HIGHTOWER N. C., Jr, OLSEN A. M., MOERSCH H. J. A comparison of the effects of acetyl-beta-methylcholine chloride (mecholyl) on esophageal intraluminal pressure in normal persons and patients with cardiospasm. Gastroenterology. 1954 Apr;26(4):592–600. [PubMed] [Google Scholar]
  12. HOFFMAN H. H., SCHNITZLEIN H. N. The numbers of nerve fibers in the vagus nerve of man. Anat Rec. 1961 Mar;139:429–435. doi: 10.1002/ar.1091390312. [DOI] [PubMed] [Google Scholar]
  13. KRAMER P., INGELFINGER F. J. Esophageal sensitivity to mecholyl in cardiospasm. Gastroenterology. 1951 Oct;19(2):242–253. [PubMed] [Google Scholar]
  14. NAGLER R., SPIRO H. M. Segmental response of the inferior esophageal sphincter to elevated intragastric pressure. Gastroenterology. 1961 Mar;40:405–407. [PubMed] [Google Scholar]
  15. OLSEN A. M., HOLMAN C. B., ANDERSEN H. A. The diagnosis of cardiospasm. Dis Chest. 1953 May;23(5):477–498. doi: 10.1378/chest.23.5.477. [DOI] [PubMed] [Google Scholar]
  16. SANCHEZ G. C., KRAMER P., INGELFINGER F. J. Motor mechanisms of the esophagus, particularly of its distal portion. Gastroenterology. 1953 Nov;25(3):321-32; discussion, 359-63. [PubMed] [Google Scholar]
  17. SLEISENGER M. H., STEINBERG H., ALMY T. P. The disturbance of esophageal motility in cardiospasm: studies on autonomic stimulation and autonomic blockade of the human esophagus, including the cardia. Gastroenterology. 1953 Nov;25(3):333-48; discussion, 359-63. [PubMed] [Google Scholar]
  18. VANGOIDSENHOVEN G. E., VANTRAPPEN G., VERBEKE S., VANDENBROUCKE J. TREATMENT OF ACHALASIA OF THE CARDIA WITH PNEUMATIC DILATIONS. Gastroenterology. 1963 Sep;45:326–334. [PubMed] [Google Scholar]
  19. VANTRAPPEN G., LIEMER M. D., IKEYA J., TEXTER E. C., Jr, BARBORKA C. J. Simultaneous fluorocinematography and intraluminal pressure measurements in the study of esophageal motility. Gastroenterology. 1958 Dec;35(6):592–602. [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES