Achalasia causes: Difference between revisions

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{{Achalasia}}
{{Achalasia}}


{{CMG}}
{{CMG}} {{AE}} {{TS}}, {{AY}}


==Overview==
==Overview==
Achalasia is chronic esophageal motility disorder.  The most common form is primary achalasia, which has no known underlying cause. It is due to the failure of distal esophageal inhibitory neurons. However, a small proportion occurs secondary to other conditions, such as [[esophageal cancer]] or [[Chagas disease]].


The main problem in achalasia is a failure of the a muscular ring where the esophagus and stomach come together (lower esophageal sphincter) to relax during swallowing.
==Causes==
===Life threatening===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.  Achalasia does not have life-threatening causes.
===Common causes===
*[[Idiopathic]]<ref name="pmid22532812">{{cite journal |vauthors=Gockel I, Müller M, Schumacher J |title=Achalasia--a disease of unknown cause that is often diagnosed too late |journal=Dtsch Arztebl Int |volume=109 |issue=12 |pages=209–14 |year=2012 |pmid=22532812 |pmc=3329145 |doi=10.3238/arztebl.2012.0209 |url=}}</ref>
*[[Chagas disease ]]


Another general cause of the disorder is a lack of nerve stimulation to the muscles of the esophagus. Causes include:
=== Less common causes ===
* [[Cancer]]s
*[[Gastric carcinoma]]<ref name="pmid22791940">{{cite journal |vauthors=Ghoshal UC, Daschakraborty SB, Singh R |title=Pathogenesis of achalasia cardia |journal=World J. Gastroenterol. |volume=18 |issue=24 |pages=3050–7 |year=2012 |pmid=22791940 |pmc=3386318 |doi=10.3748/wjg.v18.i24.3050 |url=}}</ref>
* Damage to the nerves of the esophagus
*[[Herpes zoster]]
* Infection with a [[parasite]]
*[[HSV-1]]  
* Inherited factors
*[[Measles virus]]<ref name="pmid26087861">{{cite journal |vauthors=Ates F, Vaezi MF |title=The Pathogenesis and Management of Achalasia: Current Status and Future Directions |journal=Gut Liver |volume=9 |issue=4 |pages=449–63 |year=2015 |pmid=26087861 |pmc=4477988 |doi=10.5009/gnl14446 |url=}}</ref>
 
As a result, the wave-like contractions (peristalsis) of smooth muscles that normally force food through the esophagus and other parts of the digestive tract do not work as well. Achalasia is a rare disorder. It may occur at any age, but is most common in middle-aged or older adults.
 
===Common Causes===
*[[Chagas disease ]]
*[[Amyloidosis ]]
*[[Eosinophilic gastroenteritis ]]
*[[HSV-1]] infection
*[[Neurofibromatosis ]]
*[[Paraneoplastic syndrome]]
*[[Paraneoplastic syndrome]]
*[[Sarcoidosis ]]
*[[Sarcoidosis ]]


===Causes by Organ System===
===Causes by Organ System===
{|style="width:82%; height:100px" border="1"
{| style="width:82%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Chemical/Poisoning'''
| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dental'''
| '''Dental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" |[[Multiple endocrine neoplasia type 2]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"|[[Gastric carcinoma ]] , [[Eosinophilic gastroenteritis ]] , Degeneration of [[myenteric plexus]] in [[esophagus]] , Chronic idiopathic intestinal pseudo-obstruction
| bgcolor="Beige" |[[Eosinophilic gastroenteritis]], [[esophageal cancer]], [[gastric carcinoma]], [[idiopathic intestinal pseudo-obstruction]], [[achalasia pathophysiology|myenteric plexus degeneration]], [[pancreatic cancer]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"|[[Chagas disease ]] ,  [[HSV-1]] infection
| bgcolor="Beige" |[[Chagas disease]],  [[HSV-1]], [[herpes zoster]], [[measles]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" |[[Neurofibromatosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" |[[Esophageal cancer]], [[lung carcinoma]], [[lymphoma]], [[pancreatic cancer]], [[paraneoplastic syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"|[[Sarcoidosis ]] , Juvenile [[Sjögren's syndrome]] with achalasia and [[gastric]] hypersecretion 
| bgcolor="Beige" |[[Sarcoidosis]], Juvenile [[Sjögren's syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"|[[Anderson-Fabry disease]] ,  [[Amyloidosis ]]
| bgcolor="Beige" |[[Anderson-Fabry disease]],  [[Amyloidosis]]
|-
|-
|}
|}


===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{col-break|width=33%}}
*[[Amyloidosis ]]
*[[Amyloidosis ]]
*[[Anderson-Fabry disease]]
*[[Anderson-Fabry disease]]
*[[Chagas disease ]]
*[[Chagas disease ]]
*Chronic idiopathic intestinal [[pseudo-obstruction ]]
*Degeneration of [[myenteric plexus]] in [[esophagus]]
*[[Eosinophilic gastroenteritis ]]
*[[Eosinophilic gastroenteritis ]]
*[[Esophageal cancer]],
*[[Gastric carcinoma ]]
*[[Gastric carcinoma ]]
*[[HSV-1]] infection
*[[HSV-1]]
*Increased Lower Esophageal Sphincter pressure
*[[Idiopathic intestinal pseudo-obstruction]]
*Juvenile Sjögren's syndrome with achalasia and gastric hypersecretion
*Juvenile [[Sjögren's syndrome]]
*[[Mediastinal Mass]]
{{col-break|width=33%}}
*[[Multiple endocrine neoplasia]] type 2B
*[[Lung carcinoma]],
*[[Lymphoma]],
*[[Mediastinal mass]]
*[[Multiple endocrine neoplasia type 2]]
*[[Achalasia pathophysiology|Myenteric plexus degeneration]]
*[[Neurofibromatosis ]]
*[[Neurofibromatosis ]]
*[[Paraneoplastic syndrome]]
*[[Paraneoplastic syndrome]]
*[[Sarcoidosis ]]
*[[Sarcoidosis ]]
{{col-end}}


==References==
==References==
{{Reflist|2}}


{{Reflist|2}}
[[Category:Gastroenterology]]
[[Category:Otolaryngology]]


[[Category:Needs content]]
{{WS}}
{{WH}}

Latest revision as of 14:38, 27 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Twinkle Singh, M.B.B.S. [2], Ahmed Younes M.B.B.CH [3]

Overview

Achalasia is chronic esophageal motility disorder. The most common form is primary achalasia, which has no known underlying cause. It is due to the failure of distal esophageal inhibitory neurons. However, a small proportion occurs secondary to other conditions, such as esophageal cancer or Chagas disease.

Causes

Life threatening

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Achalasia does not have life-threatening causes.

Common causes

Less common causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine Multiple endocrine neoplasia type 2
Environmental No underlying causes
Gastroenterologic Eosinophilic gastroenteritis, esophageal cancer, gastric carcinoma, idiopathic intestinal pseudo-obstruction, myenteric plexus degeneration, pancreatic cancer
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease Chagas disease, HSV-1, herpes zoster, measles
Musculoskeletal/Orthopedic No underlying causes
Neurologic Neurofibromatosis
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Esophageal cancer, lung carcinoma, lymphoma, pancreatic cancer, paraneoplastic syndrome
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Sarcoidosis, Juvenile Sjögren's syndrome
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Anderson-Fabry disease, Amyloidosis

Causes in Alphabetical Order

References

  1. ↑ Gockel I, Müller M, Schumacher J (2012). "Achalasia--a disease of unknown cause that is often diagnosed too late". Dtsch Arztebl Int. 109 (12): 209–14. doi:10.3238/arztebl.2012.0209. PMC 3329145. PMID 22532812.
  2. ↑ Ghoshal UC, Daschakraborty SB, Singh R (2012). "Pathogenesis of achalasia cardia". World J. Gastroenterol. 18 (24): 3050–7. doi:10.3748/wjg.v18.i24.3050. PMC 3386318. PMID 22791940.
  3. ↑ Ates F, Vaezi MF (2015). "The Pathogenesis and Management of Achalasia: Current Status and Future Directions". Gut Liver. 9 (4): 449–63. doi:10.5009/gnl14446. PMC 4477988. PMID 26087861.

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