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lecture describing esophageal symptoms such as heartburn with no organic causes
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Functional esophageal disorders
Dr Yasser M Fouad
Gastroenterology 2006
Causes
Motility disorder
Visceral sensory abnormalities:
- acid
- distention
Psychological factors:
-Anxiety, somatization and depression
Functional esophageal disorders
Functional heartburn Functional dysphagia Functional chest pain Functional globus
Functional heartburn
Burning Retrosternal pain or discomfort Absence of GERD Absence of motility disorders For at least 3 months with 6 months onset
Treatment
Tricyclic antidepressant Promotility drugs SSRI
Functional Chest pain
Midline chest pain or discomfort that is not of
burning quality 2. Absence of evidence that gastroesophageal
reflux is the cause of the symptom 3. Absence of histopathology-based esophageal
motility disorders Criteria fulfilled for the last 3 months with symptom
onset at least 6 months before diagnosis
Treatment
Antidepressants
Botulinum toxin injection
Functional Dysphagia
1. Sense of solid and/or liquid foods sticking, lodging, or passing abnormally through the
esophagus 2. Absence of evidence that gastroesophageal
reflux is the cause of the symptom 3. Absence of histopathology-based esophageal motility disorders *Criteria fulfilled for the last 3 months with symptom
onset at least 6 months before diagnosis
Globus
1. Persistent or intermittent, nonpainful sensation
of a lump or foreign body in the throat 2. Occurrence of the sensation between meals 3. Absence of dysphagia or odynophagia 4. Absence of evidence that gastroesophageal reflux
is the cause of the symptom 5. Absence of histopathology-based esophageal
motility disorders *Criteria fulfilled for the last 3 months with symptom
onset at least 6 months before diagnosis
Promotility agents
Metoclopramide Erythromycin Tegaserod Dompridone Mosapride
Psychotropic agents
Tricyclic antidepressants Selective serotonin reuptake inhibitors Benzodiazepines
Psychotherapy
Cognitive behavioral therapy Relaxation therapy Hypnosis Psychodynamic therapy
Alternative Therapies
Common alternative therapies include acupuncture, massage therapy, herbal remedies, hypnotherapy, therapeutic touch, aromatherapy, and color therapy.