Li JY, Zhang WH, Huang CL, Huang D, Zuo GW, Liang LX. Deanxit relieves symptoms in a patient with jackhammer esophagus: A case report. World J Gastrointest Endosc 2017; 9(12): 590-593 [PMID: 29290915 DOI: 10.4253/wjge.v9.i12.590]
Corresponding Author of This Article
Guo-Wen Zuo, MD, Department of Gastroenterology, People’s Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. mdzuoguowen@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jin-Ying Li, Wen-Huan Zhang, Chun-Ling Huang, Dang Huang, Guo-Wen Zuo, Lie-Xin Liang, Department of Gastroenterology, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Zuo GW designed the report; Li JY collected references and prepared the manuscript, with the help of Huang D; Zhang WH and Huang CL provided the figures; Zuo GW and Liang LX supervised the preparation of the manuscript.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Guo-Wen Zuo, MD, Department of Gastroenterology, People’s Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. mdzuoguowen@163.com
Telephone: +86-771-2186007 Fax: +86-771-2186007
Received: August 27, 2017 Peer-review started: August 27, 2017 First decision: October 9, 2017 Revised: October 25, 2017 Accepted: November 11, 2017 Article in press: November 11, 2017 Published online: December 16, 2017 Processing time: 102 Days and 4.5 Hours
ARTICLE HIGHLIGHTS
Case characteristics
A 60-year-old man with a 1-year history of intermittent and recurrent episodes of dysphagia, chest pain and heartburn, who had taken PPIs for a long time, but without relief of any symptoms.
Clinical diagnosis
Dysphagia, chest pain and heartburn and depressive state.
All laboratory parameters were within normal limits.
Imaging diagnosis
High-resolution manometry (HRM) showed six swallows with distal contractile integral (DCI) > 8000 mmHg-s-cm in 10 liquid swallows and integrated relaxation pressure (IRP) 14.7 mmHg.
Pathological diagnosis
Esophageal mucosa appeared as ectopia of gastric mucosa.
Treatment
Deanxit for 6 mo, gradually reduced until withdrawal.
Related reports
Jackhammer esophagus is a rare disorder, and current treatments are limited, such as botulinum toxin injection, peroral endoscopic myotomy, and balloon dilatation.
Term explanation
Jackhammer esophagus is a rare esophagus disorder, and patients with extreme phenotypes of esophageal hypercontractility present mainly with dysphagia, chest pain, and gastroesophageal reflux symptoms. Jackhammer esophagus is described by a new Chicago Classification version 3.0 with at least two swallows with DCI > 8000 mmHg-s-cm.
Experiences and lessons
Patients with esophageal hypercontractility present mainly with dysphagia, chest pain, and HRM is the primary diagnostic method. Patients may also have mental illness, so at the time of diagnosis, psychological evaluation is necessary. Antianxiety and antidepressant agents are promising medical treatment to relieve symptoms in patients with jackhammer esophagus combined with psychosocial problems, but longer follow-up is needed.
