Zusammenfassung
Ösophagusmotilitätsstörungen sind eine Gruppe von Erkrankungen, bei denen es durch Veränderungen an den die Ösophagusfunktion koordinierenden neuromuskulären Strukturen zu Fehlfunktionen des Schluckaktes kommt. Das Leitsymptom ist daher die Dysphagie für feste und/oder flüssige Speisen. Häufig treten auch Begleitsymptome wie Thoraxschmerz, Regurgitation, Sodbrennen und Gewichtsverlust auf.
Es werden primäre und sekundäre Motilitätsstörungen unterschieden. Pathophysiologie und Ätiologie, insbesondere der primären Ösophagusmotilitätsstörungen, sind oft unklar und damit auch keiner kausalen Therapie zugänglich. Neben der Achalasie (der am besten, auch hinsichtlich möglicher Behandlungen charakterisierten Ösophagusmotilitätsstörung) gibt es weitere, sowohl hyper- als auch hypomotile Funktionsstörungen der Speiseröhre. Deren Ursachen und Behandlungsmöglichkeiten sind jedoch häufig weniger gut verstanden bzw. untersucht.
Durch die Einführung der hochauflösenden Ösophagusmanometrie haben sich die Diagnostik und das Verständnis der Ösophagusmotilitätsstörungen zwar verbessert, die Therapien sind jedoch i. d. R. weiterhin auf eine Symptomreduktion begrenzt. Das primäre Ziel aller Behandlungen besteht in der Verbesserung der Speisepassage in den Magen. Erfreulicherweise stehen uns hier zunehmend mehr Verfahren zur Verfügung, welche individuell in Abhängigkeit vom Alter, Symptomen, Co-Morbidität und bei der Achalasie entsprechend der Subtypen des jeweiligen Patienten ausgewählt werden können.
In diesem Kapitel werden Diagnostik und Therapie bei Motilitätsstörungen des Ösophagus dargestellt.
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Müller, M., Denzer, U.W., Kreuser, N., Niebisch, S., Gockel, I. (2022). Motilitätsstörungen des Ösophagus. In: Kreis, M., Bartsch, D.K., Lang, H. (eds) Viszeral- und Allgemeinchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61724-3_91-1
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