Esophageal Motor Dysfunction:  in Systemic Diseases

The esophagus may be affected by such primary disorders as achalasia and diffuse spasm or by diseases that primarily affect other parts of the body, such as scleroderma. Primary esophageal disorders have been described elsewhere in this symposium. This review will be limited to a discussion of esophageal motor dysfunction associated with systemic diseases.

The systemic disorders known to be associated with esophageal motor dysfunction can be classified broadly under four major categories as follows: (1) connective tissue diseases, (2) metabolic and endocrine disorders, (3) neural, neuromuscular, and primary muscular diseases, and (4) miscellaneous conditions. Each of these categories can be subdivided as follows:

Connective tissue diseases

Scleroderma^1-32

Systemic lupus erythematosus^11,33,34

Polymyositis, dermatomyositis^32,34

Rheumatoid arthritis^34,35

Raynaud phenomenon³⁶

"Overlap" collagen syndromes^32-36

Metabolic and endocrine disorders

Diabetes mellitus^37-43

Thyrotoxicosis

Myxedema⁴⁴

Amyloidosis^45-47

Metabolic acidosis, alkalosis, and electrolyte abnormalities¹⁷

Alcoholism^48-5282

Neural, neuromuscular, and primary