부산대학교 도서관

Esophageal motility disorders are divided into primary disorders and secondary disorders. Primary esophageal motility disorders include achalasia, diffuse esophageal spasm, nutcracker esophagus, hypertensive lower esophageal sphincter and nonspecific esophageal motility disorders. Patients with hypocontraction of the esophageal body in nonspecific esophageal motility disorders are classified as an ineffective esophageal motility (IEM). Recently, a newly developed device for investigating esophageal motor functions, high-resolution manometry, was introduced and a new classification of esophageal motility disorder—the Chicago classification—was proposed. Some clinical differences in esophageal motility disorders exist between the elderly and young. We discussed these issues with references. Esophageal hiatus hernia and reflux esophagitis are common diseases in the elderly. In these cases, IEM is often recognized. Laparoscopic fundoplication with anti-reflux procedure is an effective treatment for these patients and IEM sometimes is improved. In patients with achalasia, insufficiency of LES relaxation and disorders of esophageal peristalsis are found ; here, laparoscopic Heller myotomy and Dor fundoplication is a very effective treatment for improving the patient's symptoms.