Patients with diffuse esophageal spasm or high amplitude esophageal contraction have a thicker esophageal muscularis propria than do healthy subjects.
Doctors at the University of California compared the esophageal muscle mass in patients with achalasia to that seen in healthy volunteers and patients with diffuse esophageal spasm or high amplitude esophageal contraction.
Esophageal muscle cross sectional area (MCSA) was used as an indicator of muscle mass.
Esophageal MCSA was measured from ultrasound images recorded using a high-frequency ultrasound probe catheter.
Recordings were obtained from the lower esophageal sphincter and multiple sites in the esophagus 2, 4, 6, 8, and 10 cm above the lower esophageal sphincter.
Esophageal MCSA as well as esophageal sphincter thickness was greater in patients with all 3 motility disorders than in healthy volunteers.
Esophageal muscle mass as measured by MCSA varied according to the motility disorder. Muscle thickness was greatest in achalasia, followed by diffuse esophageal spasm. Patients with high amplitude esophageal contraction had the lowest MCSA.
| Esophageal muscle thickness was greater in all three patient groups than in the normal subject group
|The American Journal of Gastroenterology|
The authors of the study conclude. “An increase in the MCSA is an important feature of patients with primary motility disorders of the esophagus”
“The degree of increase in muscle mass may be an important determinant of the type and the severity of esophageal motor dysfunction.”