Question: crest syndrome esophageal dysfunction

CREST Syndrome Clinical Presentation: History, Physical Examination, Complications CREST Syndrome Clinical Presentation
CREST Syndrome Clinical Presentation
History
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectases
Other manifestations
 Rarely, the nose and ears can be affected. Involved skin is cool during the attack, but the proximal skin is warm. Color changes are often accompanied by symptoms that can include pain and paresthesias. The phenomenon lasts minutes to hours, and the patient is symptom-free between episodes. Esophageal dysmotility
While the entire intestine can be involved in scleroderma, esophageal involvement is most common and most often clinically relevant. According to Akesson and Wollheim from 1989, [ 44] dysmotility is common. Cine-esophagram and radionuclide transit time studies demonstrate hypomotility in as many as 75-86% of patients with CREST syndrome. All patients have normal motility of the proximal esophagus, which primarily is striated muscle. In 1987, Zamost et al [ 45] correlated esophageal symptoms with anatomic and physiologic measurements in 53 patients with scleroderma. The prevalence of esophagitis and strictures (41%) in this patient population is higher than in otherwise healthy patients with gastroesophageal reflux disease.

CREST Syndrome Clinical Presentation: History, Physical Examination, Complications

CREST Syndrome Clinical Presentation
CREST Syndrome Clinical Presentation
History
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectases
Other manifestations

Rarely, the nose and ears can be affected. Involved skin is cool during the attack, but the proximal skin is warm. Color changes are often accompanied by symptoms that can include pain and paresthesias. The phenomenon lasts minutes to hours, and the patient is symptom-free between episodes. Esophageal dysmotility
While the entire intestine can be involved in scleroderma, esophageal involvement is most common and most often clinically relevant. According to Akesson and Wollheim from 1989, [ 44] dysmotility is common. Cine-esophagram and radionuclide transit time studies demonstrate hypomotility in as many as 75-86% of patients with CREST syndrome. All patients have normal motility of the proximal esophagus, which primarily is striated muscle. In 1987, Zamost et al [ 45] correlated esophageal symptoms with anatomic and physiologic measurements in 53 patients with scleroderma. The prevalence of esophagitis and strictures (41%) in this patient population is higher than in otherwise healthy patients with gastroesophageal reflux disease.

CREST Syndrome - Clinical Features, Diagnosis, Self-Care Tips and Treatment | medcaretips.com CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
Clinical Features
Cause of CREST Syndrome
Risk Factors
Complications
Gastrointestinal complications
Lung complications
Heart Complications
Kidney complications
Ulcers on fingers and toes
Endocrinal complications
Other complications
Diagnosis and Investigations
Clinical evaluation
Autoantibody tests
Complete blood counts
Nonspecific indicators of inflammation
Serum calcium and phosphorus levels
Renal function tests
Thyroid function tests
X-ray of extremities
Doppler ultrasonography or angiography
Electromyogram/nerve conduction velocity test
Pulmonary function tests
Electrocardiography and Holter monitoring
Upper GI endoscopy, esophageal manometry, barium swallow studies
CT scan
Skin biopsy
Self –Care Tips
Keep warm
Quit smoking
Exercise regularly
Healthy eating habits
To prevent acid reflux
Take care of your skin
Practice good oral hygiene
Treatment
Medicinal treatment
Pain relief medication
Antibiotics
Antacids
Medicines to treat dry mouth
Immunosuppressive drugs
Penicillamine
Calcinosis
Raynaud’s phenomenon
E sophageal dysfunction
Sclerodactyly
Telangiectasias
Treatment of complications
References
About Dr Surbhi Mahajan
 Exposure to toxins like polyvinyl chloride, benzene, silica, etc can trigger CREST syndrome in people who have a genetic predisposition for the disease. Complications
In contrast with diffuse scleroderma, CREST syndrome is associated with better survival rates and a lower incidence of complications. Mortality in patients with limited skin involvement is a result of pulmonary, cardiac, and gastrointestinal causes. Gastrointestinal complications
Fibrosis of the distal esophagus may lead to dysphagia (difficulty in swallowing), chronic heartburn, esophageal strictures and even bleeding. Involvement of the stomach can lead to delayed gastric emptying resulting in early satiety. Intestinal involvement can cause bloating, constipation, diarrhea, nausea, vomiting, and anorexia leading to malnutrition and weight loss. Lung complications
It is the leading cause of deaths in patients of CREST syndrome as it may cause progressive respiratory failure. The deposition of excess collagen in between the air sacs of the lungs makes the lung tissue stiffer resulting in reduced functioning of the lungs. It may also cause pulmonary artery hypertension (increased blood pressure in the arteries between the heart and lungs) which may ultimately lead to cor pulmonale (heart failure). Heart Complications
Fibrosis and scarring of heart tissue can result in arrhythmias (abnormal heart rhythms) or dilated cardiomyopathy (enlargement and weakening of the heart).

CREST Syndrome - Clinical Features, Diagnosis, Self-Care Tips and Treatment | medcaretips.com

CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
Clinical Features
Cause of CREST Syndrome
Risk Factors
Complications
Gastrointestinal complications
Lung complications
Heart Complications
Kidney complications
Ulcers on fingers and toes
Endocrinal complications
Other complications
Diagnosis and Investigations
Clinical evaluation
Autoantibody tests
Complete blood counts
Nonspecific indicators of inflammation
Serum calcium and phosphorus levels
Renal function tests
Thyroid function tests
X-ray of extremities
Doppler ultrasonography or angiography
Electromyogram/nerve conduction velocity test
Pulmonary function tests
Electrocardiography and Holter monitoring
Upper GI endoscopy, esophageal manometry, barium swallow studies
CT scan
Skin biopsy
Self –Care Tips
Keep warm
Quit smoking
Exercise regularly
Healthy eating habits
To prevent acid reflux
Take care of your skin
Practice good oral hygiene
Treatment
Medicinal treatment
Pain relief medication
Antibiotics
Antacids
Medicines to treat dry mouth
Immunosuppressive drugs
Penicillamine
Calcinosis
Raynaud’s phenomenon
E sophageal dysfunction
Sclerodactyly
Telangiectasias
Treatment of complications
References
About Dr Surbhi Mahajan

Exposure to toxins like polyvinyl chloride, benzene, silica, etc can trigger CREST syndrome in people who have a genetic predisposition for the disease. Complications
In contrast with diffuse scleroderma, CREST syndrome is associated with better survival rates and a lower incidence of complications. Mortality in patients with limited skin involvement is a result of pulmonary, cardiac, and gastrointestinal causes. Gastrointestinal complications
Fibrosis of the distal esophagus may lead to dysphagia (difficulty in swallowing), chronic heartburn, esophageal strictures and even bleeding. Involvement of the stomach can lead to delayed gastric emptying resulting in early satiety. Intestinal involvement can cause bloating, constipation, diarrhea, nausea, vomiting, and anorexia leading to malnutrition and weight loss. Lung complications
It is the leading cause of deaths in patients of CREST syndrome as it may cause progressive respiratory failure. The deposition of excess collagen in between the air sacs of the lungs makes the lung tissue stiffer resulting in reduced functioning of the lungs. It may also cause pulmonary artery hypertension (increased blood pressure in the arteries between the heart and lungs) which may ultimately lead to cor pulmonale (heart failure). Heart Complications
Fibrosis and scarring of heart tissue can result in arrhythmias (abnormal heart rhythms) or dilated cardiomyopathy (enlargement and weakening of the heart).

CREST syndrome - Wikipedia CREST syndrome
CREST syndrome
Contents
Signs and symptoms
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
Other
Cause
Diagnosis
Treatment
Epidemiology
History
See also
References
External links
 X-ray of subtle calcifications in CREST syndrome. Calcinosis
CREST causes thickening and tightening of the skin with deposition of calcific nodules ("calcinosis"). Raynaud's phenomenon
Raynaud's phenomenon is frequently the first manifestation of CREST/lcSSc, preceding other symptoms by years. Stress and cold temperature induce an exaggerated vasoconstriction of the small arteries, arterioles, and thermoregulatory vessels of the skin of the digits. Clinically this manifests as a white-blue-red transition in skin color. Underlying this transition is pallor and cyanosis of the digits, followed by a reactive hyperemia as they rewarm. When extreme and frequent, this phenomenon can lead to digital ulcerations, gangrene, or amputation. Ulceration can predispose to chronic infections of the involved site. Esophageal dysmotility
Presents as a sensation of food getting stuck ( dysphagia) in the mid- or lower esophagus, atypical chest pain, or cough. People often state they must drink liquids to swallow solid food.

CREST syndrome - Wikipedia

CREST syndrome
CREST syndrome
Contents
Signs and symptoms
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
Other
Cause
Diagnosis
Treatment
Epidemiology
History
See also
References
External links

X-ray of subtle calcifications in CREST syndrome. Calcinosis
CREST causes thickening and tightening of the skin with deposition of calcific nodules ("calcinosis"). Raynaud's phenomenon
Raynaud's phenomenon is frequently the first manifestation of CREST/lcSSc, preceding other symptoms by years. Stress and cold temperature induce an exaggerated vasoconstriction of the small arteries, arterioles, and thermoregulatory vessels of the skin of the digits. Clinically this manifests as a white-blue-red transition in skin color. Underlying this transition is pallor and cyanosis of the digits, followed by a reactive hyperemia as they rewarm. When extreme and frequent, this phenomenon can lead to digital ulcerations, gangrene, or amputation. Ulceration can predispose to chronic infections of the involved site. Esophageal dysmotility
Presents as a sensation of food getting stuck ( dysphagia) in the mid- or lower esophagus, atypical chest pain, or cough. People often state they must drink liquids to swallow solid food.

CREST syndrome symptoms, treatments & forums | PatientsLikeMe CREST syndrome
CREST syndrome
We’re all in this for good.
What is CREST syndrome?
Common symptoms reported by people with CREST syndrome
Treatments taken by people for CREST syndrome
Compare treatments taken by people with CREST syndrome
Who has CREST syndrome on PatientsLikeMe?
Age at first symptom
Sex
Diagnosis status
 What is CREST syndrome? CREST Syndrome is a form of scleroderma that is characterized by least two of the following symptoms: calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia. Common symptoms reported by people with CREST syndrome
Common symptoms
How bad it is
What people are taking for it
Common symptom
Pain
How bad it is
13 CREST syndrome patients report severe pain (30%)
18 CREST syndrome patients report moderate pain (42%)
10 CREST syndrome patients report mild pain (23%)
1 a CREST syndrome patient reports no pain (2%)
What people are taking for it
Acupuncture Ibuprofen Meloxicam
Common symptom
Fatigue
How bad it is
9 CREST syndrome patients report severe fatigue (20%)
20 CREST syndrome patients report moderate fatigue (46%)
12 CREST syndrome patients report mild fatigue (27%)
2 CREST syndrome patients report no fatigue (4%)
What people are taking for it
Amphetamine-Dextroamphetamine Rest Shower/Tub Chair
Common symptom
Stress
How bad it is
3 CREST syndrome patients report severe stress (14%)
11 CREST syndrome patients report moderate stress (52%)
7 CREST syndrome patients report mild stress (33%)
0 CREST syndrome patients report no stress (0%)
What people are taking for it
Nothing reported yet
Common symptom
Anxious mood
How bad it is
5 CREST syndrome patients report severe anxious mood (12%)
17 CREST syndrome patients report moderate anxious mood (41%)
10 CREST syndrome patients report mild anxious mood (24%)
9 CREST syndrome patients report no anxious mood (21%)
What people are taking for it
Bupropion Diazepam
Common symptom
Depressed mood
How bad it is
4 CREST syndrome patients report severe depressed mood (9%)
10 CREST syndrome patients report moderate depressed mood (23%)
17 CREST syndrome patients report mild depressed mood (40%)
11 CREST syndrome patients report no depressed mood (26%)
What people are taking for it
Fluoxetine Bupropion
Reports may be affected by other conditions and/or medication side effects. We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 15, 2021
Treatments taken by people for CREST syndrome
Let’s build this page together! When you share what it’s like to have CREST syndrome through your profile, those stories and data appear here too. Got a question about living with CREST syndrome? Members in the forum might have the answers.

CREST syndrome symptoms, treatments & forums | PatientsLikeMe

CREST syndrome
CREST syndrome
We’re all in this for good.
What is CREST syndrome?
Common symptoms reported by people with CREST syndrome
Treatments taken by people for CREST syndrome
Compare treatments taken by people with CREST syndrome
Who has CREST syndrome on PatientsLikeMe?
Age at first symptom
Sex
Diagnosis status

CREST Syndrome - Clinical Features, Diagnosis, Self-Care Tips and Treatment | medcaretips.com CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
Clinical Features
Cause of CREST Syndrome
Risk Factors
Complications
Gastrointestinal complications
Lung complications
Heart Complications
Kidney complications
Ulcers on fingers and toes
Endocrinal complications
Other complications
Diagnosis and Investigations
Clinical evaluation
Autoantibody tests
Complete blood counts
Nonspecific indicators of inflammation
Serum calcium and phosphorus levels
Renal function tests
Thyroid function tests
X-ray of extremities
Doppler ultrasonography or angiography
Electromyogram/nerve conduction velocity test
Pulmonary function tests
Electrocardiography and Holter monitoring
Upper GI endoscopy, esophageal manometry, barium swallow studies
CT scan
Skin biopsy
Self –Care Tips
Keep warm
Quit smoking
Exercise regularly
Healthy eating habits
To prevent acid reflux
Take care of your skin
Practice good oral hygiene
Treatment
Medicinal treatment
Pain relief medication
Antibiotics
Antacids
Medicines to treat dry mouth
Immunosuppressive drugs
Penicillamine
Calcinosis
Raynaud’s phenomenon
E sophageal dysfunction
Sclerodactyly
Telangiectasias
Treatment of complications
References
About Dr Surbhi Mahajan
 Race: It is more common and severe in blacks and Native Americans than in whites. Genetic factors: Presence of any autoimmune disease in the family increases the risk of developing CREST syndrome. Environmental factors: Exposure to toxins like polyvinyl chloride, benzene, silica, etc can trigger CREST syndrome in people who have a genetic predisposition for the disease. Complications
In contrast with diffuse scleroderma, CREST syndrome is associated with better survival rates and a lower incidence of complications. Mortality in patients with limited skin involvement is a result of pulmonary, cardiac, and gastrointestinal causes. Gastrointestinal complications
Fibrosis of the distal esophagus may lead to dysphagia (difficulty in swallowing), chronic heartburn, esophageal strictures and even bleeding. Involvement of the stomach can lead to delayed gastric emptying resulting in early satiety.

Race: It is more common and severe in blacks and Native Americans than in whites. Genetic factors: Presence of any autoimmune disease in the family increases the risk of developing CREST syndrome. Environmental factors: Exposure to toxins like polyvinyl chloride, benzene, silica, etc can trigger CREST syndrome in people who have a genetic predisposition for the disease. Complications
In contrast with diffuse scleroderma, CREST syndrome is associated with better survival rates and a lower incidence of complications. Mortality in patients with limited skin involvement is a result of pulmonary, cardiac, and gastrointestinal causes. Gastrointestinal complications
Fibrosis of the distal esophagus may lead to dysphagia (difficulty in swallowing), chronic heartburn, esophageal strictures and even bleeding. Involvement of the stomach can lead to delayed gastric emptying resulting in early satiety.

DermIS - CREST Syndrome (information on the diagnosis)
CREST Syndrome
definition
synonyms
UMLS
images
 DermIS - CREST Syndrome (information on the diagnosis)
CREST Syndrome
definition
This form of systemic scleroderma is usually less severe than other forms, consisting of calcinosis cutis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasis. If there is no esophageal dysfunction present, the disorder is is known as CRST syndrome. These forms of scleroderma are rare in children. synonyms
CREST Syndrome
UMLS
Calc/Rayn/sclerodact/oes/telan, Calcinos, Raynaud, sclerodactyly, esophageal, telangiect, Calcinos, Raynaud, sclerodactyly, oesophageal, telangiect, Calcinosis cutis, Raynaud's, esophageal dysfunction, sclerodactyly and telangiectasia, Calcinosis, Raynaud's phenomenon, sclerodactyly, esophageal dysfunction, telangiectasia syndrome, Calcinosis, Raynaud's phenomenon, sclerodactyly, oesophageal dysfunction, telangiectasia syndrome, CREST, CREST - Calc, Raynaud, sclerodact, oesoph, telangiect, CREST - Calc,Rayn phen,oesoph dysf,sclerodact,telangiectasia, CREST - Calc/Rayn/scl/oes/tel, CREST - Calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia, CREST - Calcinosis, Raynaud's phenomenon, oesophageal dysfunction, sclerodactyly, telangiectasia, CREST - Calcinosis, Raynaud's phenomenon, sclerodactyly, esophageal involvement, telangiectasia synd, CREST - Calcinosis, Raynaud's phenomenon, sclerodactyly, oesophageal involvement, telangiectasia syn, CREST Syndrome, CREST VARIANT OF SCLERODERMA, Syndrome, CREST
images
5 images found for this diagnose

DermIS - CREST Syndrome (information on the diagnosis)

CREST Syndrome
definition
synonyms
UMLS
images

DermIS - CREST Syndrome (information on the diagnosis)
CREST Syndrome
definition
This form of systemic scleroderma is usually less severe than other forms, consisting of calcinosis cutis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasis. If there is no esophageal dysfunction present, the disorder is is known as CRST syndrome. These forms of scleroderma are rare in children. synonyms
CREST Syndrome
UMLS
Calc/Rayn/sclerodact/oes/telan, Calcinos, Raynaud, sclerodactyly, esophageal, telangiect, Calcinos, Raynaud, sclerodactyly, oesophageal, telangiect, Calcinosis cutis, Raynaud's, esophageal dysfunction, sclerodactyly and telangiectasia, Calcinosis, Raynaud's phenomenon, sclerodactyly, esophageal dysfunction, telangiectasia syndrome, Calcinosis, Raynaud's phenomenon, sclerodactyly, oesophageal dysfunction, telangiectasia syndrome, CREST, CREST - Calc, Raynaud, sclerodact, oesoph, telangiect, CREST - Calc,Rayn phen,oesoph dysf,sclerodact,telangiectasia, CREST - Calc/Rayn/scl/oes/tel, CREST - Calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia, CREST - Calcinosis, Raynaud's phenomenon, oesophageal dysfunction, sclerodactyly, telangiectasia, CREST - Calcinosis, Raynaud's phenomenon, sclerodactyly, esophageal involvement, telangiectasia synd, CREST - Calcinosis, Raynaud's phenomenon, sclerodactyly, oesophageal involvement, telangiectasia syn, CREST Syndrome, CREST VARIANT OF SCLERODERMA, Syndrome, CREST
images
5 images found for this diagnose

CREST Syndrome Clinical Presentation: History, Physical Examination, Complications CREST Syndrome Clinical Presentation
CREST Syndrome Clinical Presentation
History
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectases
Other manifestations
 According to Akesson and Wollheim from 1989, [ 44] dysmotility is common. Cine-esophagram and radionuclide transit time studies demonstrate hypomotility in as many as 75-86% of patients with CREST syndrome. All patients have normal motility of the proximal esophagus, which primarily is striated muscle. In 1987, Zamost et al [ 45] correlated esophageal symptoms with anatomic and physiologic measurements in 53 patients with scleroderma. The prevalence of esophagitis and strictures (41%) in this patient population is higher than in otherwise healthy patients with gastroesophageal reflux disease. Abnormal motility was a significant predictor of erosive esophagitis; 70% of patients with dysmotility had gross or microscopic evidence of erosive esophagitis. No patients with normal motility had erosive esophagitis. Symptoms of heartburn and dysphagia were more common in patients with erosive esophagitis. Heartburn alone did not predict esophagitis;

According to Akesson and Wollheim from 1989, [ 44] dysmotility is common. Cine-esophagram and radionuclide transit time studies demonstrate hypomotility in as many as 75-86% of patients with CREST syndrome. All patients have normal motility of the proximal esophagus, which primarily is striated muscle. In 1987, Zamost et al [ 45] correlated esophageal symptoms with anatomic and physiologic measurements in 53 patients with scleroderma. The prevalence of esophagitis and strictures (41%) in this patient population is higher than in otherwise healthy patients with gastroesophageal reflux disease. Abnormal motility was a significant predictor of erosive esophagitis; 70% of patients with dysmotility had gross or microscopic evidence of erosive esophagitis. No patients with normal motility had erosive esophagitis. Symptoms of heartburn and dysphagia were more common in patients with erosive esophagitis. Heartburn alone did not predict esophagitis;

CREST syndrome • AARDA
 CREST syndrome • AARDA
0
CREST syndrome
CREST syndrome is an acronym for calcinosis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia
CREST syndrome is an acronym for c alcinosis, R aynaud’s phenomenon, e sophageal dysfunction, s clerodactyly, and t elangiectasia. It is a variant of the two groups of scleroderma, localized and systemic. CREST is a relatively stable and slow-moving form of scleroderma and has a much more favorable prognosis than other forms. There is no evidence that the basic process differs from the usual scleroderma, but the tempo of CREST seems to be different in that organ involvement comes slower and later in the course of the disease. « Back to Glossary Index
AARDA
Comments are closed.

CREST syndrome • AARDA

CREST syndrome • AARDA
0
CREST syndrome
CREST syndrome is an acronym for calcinosis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia
CREST syndrome is an acronym for c alcinosis, R aynaud’s phenomenon, e sophageal dysfunction, s clerodactyly, and t elangiectasia. It is a variant of the two groups of scleroderma, localized and systemic. CREST is a relatively stable and slow-moving form of scleroderma and has a much more favorable prognosis than other forms. There is no evidence that the basic process differs from the usual scleroderma, but the tempo of CREST seems to be different in that organ involvement comes slower and later in the course of the disease. « Back to Glossary Index
AARDA
Comments are closed.

CREST syndrome causes, signs, symptoms, diagnosis & treatment CREST syndrome
CREST syndrome
What is CREST syndrome
Is CREST syndrome fatal?
What is systemic sclerosis?
Systemic sclerosis has been subdivided into 2 main subtypes, according to the distribution of skin involvement.
Key features of systemic sclerosis
Systemic sclerosis causes
Genetic susceptibility
Triggering event
Immune pathways
Paraneoplastic systemic sclerosis
Systemic sclerosis pathophysiology
Systemic sclerosis symptoms
Cutaneous features of systemic sclerosis
Skin sclerosis
Hands
Face
Other
Rarer cutaneous features
Gastrointestinal symptoms
Upper gastrointestinal tract
Lower gastrointestinal tract
Cardiopulmonary symptoms
Renal disease
Other symptoms
Systemic sclerosis diagnosis
Investigations may include:
Systemic sclerosis treatment
General advice
Anti-fibrotic therapies
Topical therapies:
Physical therapies:
Systemic therapies:
Vasodilation
Treatment of skin manifestations
Raynaud phenomenon
Digital ulcers
Telangiectases
Calcinosis
Pruritus
Facial fat loss
Treatment of internal organ manifestations
Interstitial lung disease
Pulmonary artery hypertension
Renal disease
Gastrointestinal tract
Systemic sclerosis monitoring
Skin
Internal organs
CREST syndrome causes
Risk factors for CREST syndrome
CREST syndrome symptoms
CREST syndrome symptoms and signs include:
CREST syndrome complications
CREST syndrome diagnosis
CREST syndrome treatment
Medications
Therapy
Surgery
CREST syndrome life expectancy
MOST POPULAR
 The skin changes associated with limited scleroderma typically occur only in the lower arms and legs, below the elbows and knees, and sometimes affect the face and neck. Limited scleroderma can also affect your digestive tract, heart, lungs or kidneys. The symptoms involved in CREST syndrome are associated with the generalized form of the disease systemic sclerosis (scleroderma). CREST is an acronym for the clinical features that are seen in a patient with this disease. (C) – Calcinosis: calcium deposits in the connective tissues
(R) – Raynaud’s phenomenon: where the hands and feet turn white and cold and then blue, in response to cold or anxiety
(E) – Esophageal dysfunction resulting in swallowing difficulty
(S) – Sclerodactyly: thick and tight skin on the fingers, caused by an excess of collagen deposits within skin layers. (T) – Telangiectasia: small red spots on the hands and face that are caused by the swelling of tiny blood vessels.

CREST syndrome causes, signs, symptoms, diagnosis & treatment

CREST syndrome
CREST syndrome
What is CREST syndrome
Is CREST syndrome fatal?
What is systemic sclerosis?
Systemic sclerosis has been subdivided into 2 main subtypes, according to the distribution of skin involvement.
Key features of systemic sclerosis
Systemic sclerosis causes
Genetic susceptibility
Triggering event
Immune pathways
Paraneoplastic systemic sclerosis
Systemic sclerosis pathophysiology
Systemic sclerosis symptoms
Cutaneous features of systemic sclerosis
Skin sclerosis
Hands
Face
Other
Rarer cutaneous features
Gastrointestinal symptoms
Upper gastrointestinal tract
Lower gastrointestinal tract
Cardiopulmonary symptoms
Renal disease
Other symptoms
Systemic sclerosis diagnosis
Investigations may include:
Systemic sclerosis treatment
General advice
Anti-fibrotic therapies
Topical therapies:
Physical therapies:
Systemic therapies:
Vasodilation
Treatment of skin manifestations
Raynaud phenomenon
Digital ulcers
Telangiectases
Calcinosis
Pruritus
Facial fat loss
Treatment of internal organ manifestations
Interstitial lung disease
Pulmonary artery hypertension
Renal disease
Gastrointestinal tract
Systemic sclerosis monitoring
Skin
Internal organs
CREST syndrome causes
Risk factors for CREST syndrome
CREST syndrome symptoms
CREST syndrome symptoms and signs include:
CREST syndrome complications
CREST syndrome diagnosis
CREST syndrome treatment
Medications
Therapy
Surgery
CREST syndrome life expectancy
MOST POPULAR

The skin changes associated with limited scleroderma typically occur only in the lower arms and legs, below the elbows and knees, and sometimes affect the face and neck. Limited scleroderma can also affect your digestive tract, heart, lungs or kidneys. The symptoms involved in CREST syndrome are associated with the generalized form of the disease systemic sclerosis (scleroderma). CREST is an acronym for the clinical features that are seen in a patient with this disease. (C) – Calcinosis: calcium deposits in the connective tissues
(R) – Raynaud’s phenomenon: where the hands and feet turn white and cold and then blue, in response to cold or anxiety
(E) – Esophageal dysfunction resulting in swallowing difficulty
(S) – Sclerodactyly: thick and tight skin on the fingers, caused by an excess of collagen deposits within skin layers. (T) – Telangiectasia: small red spots on the hands and face that are caused by the swelling of tiny blood vessels.

CREST syndrome symptoms, treatments & forums | PatientsLikeMe CREST syndrome
CREST syndrome
We’re all in this for good.
What is CREST syndrome?
Common symptoms reported by people with CREST syndrome
Treatments taken by people for CREST syndrome
Compare treatments taken by people with CREST syndrome
Who has CREST syndrome on PatientsLikeMe?
Age at first symptom
Sex
Diagnosis status
 Interacting with other PatientsLikeMe members improves your health. Read it on healthaffairs.org . The severity of Parkinson's Disease symptoms changes faster than researchers thought, so clinical trials should be designed differently. Read about it on JMIR . And more! What is CREST syndrome? CREST Syndrome is a form of scleroderma that is characterized by least two of the following symptoms: calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia. Common symptoms reported by people with CREST syndrome
Common symptoms
How bad it is
What people are taking for it
Common symptom
Pain
How bad it is
13 CREST syndrome patients report severe pain (30%)
18 CREST syndrome patients report moderate pain (42%)
10 CREST syndrome patients report mild pain (23%)
1 a CREST syndrome patient reports no pain (2%)
What people are taking for it
Acupuncture Ibuprofen Meloxicam
Common symptom
Fatigue
How bad it is
9 CREST syndrome patients report severe fatigue (20%)
20 CREST syndrome patients report moderate fatigue (46%)
12 CREST syndrome patients report mild fatigue (27%)
2 CREST syndrome patients report no fatigue (4%)
What people are taking for it
Amphetamine-Dextroamphetamine Rest Shower/Tub Chair
Common symptom
Stress
How bad it is
3 CREST syndrome patients report severe stress (14%)
11 CREST syndrome patients report moderate stress (52%)
7 CREST syndrome patients report mild stress (33%)
0 CREST syndrome patients report no stress (0%)
What people are taking for it
Nothing reported yet
Common symptom
Anxious mood
How bad it is
5 CREST syndrome patients report severe anxious mood (12%)
17 CREST syndrome patients report moderate anxious mood (41%)
10 CREST syndrome patients report mild anxious mood (24%)
9 CREST syndrome patients report no anxious mood (21%)
What people are taking for it
Bupropion Diazepam
Common symptom
Depressed mood
How bad it is
4 CREST syndrome patients report severe depressed mood (9%)
10 CREST syndrome patients report moderate depressed mood (23%)
17 CREST syndrome patients report mild depressed mood (40%)
11 CREST syndrome patients report no depressed mood (26%)
What people are taking for it
Fluoxetine Bupropion
Reports may be affected by other conditions and/or medication side effects. We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition.

Limited Scleroderma (CREST Syndrome) Limited Scleroderma (CREST Syndrome)
Limited Scleroderma (CREST Syndrome)
Overview
Causes and Risk Factors
Symptoms
Diagnosis and Treatment
Prevention
Sources
Additional Resources
Home Health Testing Guides
Testing Company Reviews
 Limited Scleroderma (CREST Syndrome)
Limited Scleroderma (CREST Syndrome)
By: Tina Shahian, PhD
Last Updated: Mar 1, 2019
Overview
Limited scleroderma (also known as CREST syndrome) is a type of scleroderma, which as the name implies is characterized by thick, hardened skin. In the more severe form, this connective tissue disorder can affect the function of internal organs (e.g., esophagus, heart, lungs, gastrointestinal tract, muscle and joints) and even become life threatening. Limited scleroderma is milder form of the disease and affects roughly 50% of scleroderma patients. It is often referred to as CREST syndrome, with each letter representing one of five common features ( see Symptoms) of the illness: C alcinosis
R aynaud phenomenon (also called Raynaud’s phenomenon or Raynaud’s disease)
E sophageal dysfunction
S clerodactyly
T elangiectasia
The skin hardening associated with limited scleroderma is typically confined to the fingers, hands, lower arms, legs and face. Unlike its more severe form, progression is more gradual and complications involving internal organs are less common. Limited scleroderma can affect the digestive tract, causing difficulty swallowing and frequent heartburn. It can also affect the blood vessels, heart and lungs, leading to hypertension and shortness of breath.

Limited Scleroderma (CREST Syndrome)

Limited Scleroderma (CREST Syndrome)
Limited Scleroderma (CREST Syndrome)
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Limited Scleroderma (CREST Syndrome)
Limited Scleroderma (CREST Syndrome)
By: Tina Shahian, PhD
Last Updated: Mar 1, 2019
Overview
Limited scleroderma (also known as CREST syndrome) is a type of scleroderma, which as the name implies is characterized by thick, hardened skin. In the more severe form, this connective tissue disorder can affect the function of internal organs (e.g., esophagus, heart, lungs, gastrointestinal tract, muscle and joints) and even become life threatening. Limited scleroderma is milder form of the disease and affects roughly 50% of scleroderma patients. It is often referred to as CREST syndrome, with each letter representing one of five common features ( see Symptoms) of the illness: C alcinosis
R aynaud phenomenon (also called Raynaud’s phenomenon or Raynaud’s disease)
E sophageal dysfunction
S clerodactyly
T elangiectasia
The skin hardening associated with limited scleroderma is typically confined to the fingers, hands, lower arms, legs and face. Unlike its more severe form, progression is more gradual and complications involving internal organs are less common. Limited scleroderma can affect the digestive tract, causing difficulty swallowing and frequent heartburn. It can also affect the blood vessels, heart and lungs, leading to hypertension and shortness of breath.

CREST Syndrome - Clinical Features, Diagnosis, Self-Care Tips and Treatment | medcaretips.com CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
Clinical Features
Cause of CREST Syndrome
Risk Factors
Complications
Gastrointestinal complications
Lung complications
Heart Complications
Kidney complications
Ulcers on fingers and toes
Endocrinal complications
Other complications
Diagnosis and Investigations
Clinical evaluation
Autoantibody tests
Complete blood counts
Nonspecific indicators of inflammation
Serum calcium and phosphorus levels
Renal function tests
Thyroid function tests
X-ray of extremities
Doppler ultrasonography or angiography
Electromyogram/nerve conduction velocity test
Pulmonary function tests
Electrocardiography and Holter monitoring
Upper GI endoscopy, esophageal manometry, barium swallow studies
CT scan
Skin biopsy
Self –Care Tips
Keep warm
Quit smoking
Exercise regularly
Healthy eating habits
To prevent acid reflux
Take care of your skin
Practice good oral hygiene
Treatment
Medicinal treatment
Pain relief medication
Antibiotics
Antacids
Medicines to treat dry mouth
Immunosuppressive drugs
Penicillamine
Calcinosis
Raynaud’s phenomenon
E sophageal dysfunction
Sclerodactyly
Telangiectasias
Treatment of complications
References
About Dr Surbhi Mahajan
 Clinical Features
Image credit: medlineplus.gov
C alcinosis – thickening and tightening of the skin with painful nodules of calcium in the skin. It can involve the fingers or other parts of the body. R aynaud’s phenomenon – White, blue, cold, or numb skin on the hands and feet in response to cold or emotional stress. It occurs due to the spasm of the blood vessels which causes blockage of the flow of blood. Once the blood circulation improves, the skin becomes reddened and painful. It is usually the first manifestation of CREST syndrome. E sophageal dysfunction – Poor functioning of the muscles of the esophagus (the tube that connects the mouth to the stomach) results in difficulty in swallowing food, chest pain, or cough. It may also cause acids from the stomach to enter back into the esophagus, resulting in heartburn or inflammation and scarring of the esophagus. S clerodactyly – Thickening and tightening of the skin of fingers or toes which makes bending of the fingers difficult.

Clinical Features
Image credit: medlineplus.gov
C alcinosis – thickening and tightening of the skin with painful nodules of calcium in the skin. It can involve the fingers or other parts of the body. R aynaud’s phenomenon – White, blue, cold, or numb skin on the hands and feet in response to cold or emotional stress. It occurs due to the spasm of the blood vessels which causes blockage of the flow of blood. Once the blood circulation improves, the skin becomes reddened and painful. It is usually the first manifestation of CREST syndrome. E sophageal dysfunction – Poor functioning of the muscles of the esophagus (the tube that connects the mouth to the stomach) results in difficulty in swallowing food, chest pain, or cough. It may also cause acids from the stomach to enter back into the esophagus, resulting in heartburn or inflammation and scarring of the esophagus. S clerodactyly – Thickening and tightening of the skin of fingers or toes which makes bending of the fingers difficult.

CREST Syndrome - Clinical Features, Diagnosis, Self-Care Tips and Treatment | medcaretips.com CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
Clinical Features
Cause of CREST Syndrome
Risk Factors
Complications
Gastrointestinal complications
Lung complications
Heart Complications
Kidney complications
Ulcers on fingers and toes
Endocrinal complications
Other complications
Diagnosis and Investigations
Clinical evaluation
Autoantibody tests
Complete blood counts
Nonspecific indicators of inflammation
Serum calcium and phosphorus levels
Renal function tests
Thyroid function tests
X-ray of extremities
Doppler ultrasonography or angiography
Electromyogram/nerve conduction velocity test
Pulmonary function tests
Electrocardiography and Holter monitoring
Upper GI endoscopy, esophageal manometry, barium swallow studies
CT scan
Skin biopsy
Self –Care Tips
Keep warm
Quit smoking
Exercise regularly
Healthy eating habits
To prevent acid reflux
Take care of your skin
Practice good oral hygiene
Treatment
Medicinal treatment
Pain relief medication
Antibiotics
Antacids
Medicines to treat dry mouth
Immunosuppressive drugs
Penicillamine
Calcinosis
Raynaud’s phenomenon
E sophageal dysfunction
Sclerodactyly
Telangiectasias
Treatment of complications
References
About Dr Surbhi Mahajan
 Once the blood circulation improves, the skin becomes reddened and painful. It is usually the first manifestation of CREST syndrome. E sophageal dysfunction – Poor functioning of the muscles of the esophagus (the tube that connects the mouth to the stomach) results in difficulty in swallowing food, chest pain, or cough. It may also cause acids from the stomach to enter back into the esophagus, resulting in heartburn or inflammation and scarring of the esophagus. S clerodactyly – Thickening and tightening of the skin of fingers or toes which makes bending of the fingers difficult. Initially, the skin appears edematous and inflamed while in later stages, the skin becomes tightened. Many patients may develop ulcers on the distal fingers. T elangiectasias — Swelling of small blood vessels near the skin’s surface results in small red spots or lines on the skin. They are painless and occur mainly on the hands and face. Cause of CREST Syndrome
The exact cause of CREST syndrome is not known.

Once the blood circulation improves, the skin becomes reddened and painful. It is usually the first manifestation of CREST syndrome. E sophageal dysfunction – Poor functioning of the muscles of the esophagus (the tube that connects the mouth to the stomach) results in difficulty in swallowing food, chest pain, or cough. It may also cause acids from the stomach to enter back into the esophagus, resulting in heartburn or inflammation and scarring of the esophagus. S clerodactyly – Thickening and tightening of the skin of fingers or toes which makes bending of the fingers difficult. Initially, the skin appears edematous and inflamed while in later stages, the skin becomes tightened. Many patients may develop ulcers on the distal fingers. T elangiectasias — Swelling of small blood vessels near the skin’s surface results in small red spots or lines on the skin. They are painless and occur mainly on the hands and face. Cause of CREST Syndrome
The exact cause of CREST syndrome is not known.

Scleroderma Overview - Scleroderma Education Project Scleroderma Overview
Scleroderma Overview
Affected Population
Causes
Symptoms
The Guide
 Patients with limited scleroderma are less likely to develop severe lung, heart, or kidney involvement than patients with diffuse disease, although all of these complications can occur late in the disease process. Many patients with limited scleroderma eventually develop a cluster of symptoms that are listed using the acronym CREST – the old name for limited scleroderma. CREST is an acronym derived from the syndrome’s five most prominent symptoms: C – calcinosis, painful calcium deposits in the skin. It presents as small, localized, hard masses on fingers, forearms, or other pressure points. R – Raynaud’s phenomenon. Raynaud’s phenomenon is characterized by the intermittent loss of blood to various parts of the body – particularly the fingers, toes, nose, and/or ears after exposure to cold and causes tingling sensations, numbness, and/or pain. This can result in ulceration and necrosis of the fingertips and in some severe cases, lead to amputation of the affected digits. E – esophageal dysfunction, reflux (heartburn), difficulty swallowing caused by internal scarring. If the heartburn symptoms are not well controlled, the repeated acid exposure can eventually lead to a condition known as Barrett’s esophagus, a pre-cancerous condition.

Scleroderma Overview - Scleroderma Education Project

Scleroderma Overview
Scleroderma Overview
Affected Population
Causes
Symptoms
The Guide

Patients with limited scleroderma are less likely to develop severe lung, heart, or kidney involvement than patients with diffuse disease, although all of these complications can occur late in the disease process. Many patients with limited scleroderma eventually develop a cluster of symptoms that are listed using the acronym CREST – the old name for limited scleroderma. CREST is an acronym derived from the syndrome’s five most prominent symptoms: C – calcinosis, painful calcium deposits in the skin. It presents as small, localized, hard masses on fingers, forearms, or other pressure points. R – Raynaud’s phenomenon. Raynaud’s phenomenon is characterized by the intermittent loss of blood to various parts of the body – particularly the fingers, toes, nose, and/or ears after exposure to cold and causes tingling sensations, numbness, and/or pain. This can result in ulceration and necrosis of the fingertips and in some severe cases, lead to amputation of the affected digits. E – esophageal dysfunction, reflux (heartburn), difficulty swallowing caused by internal scarring. If the heartburn symptoms are not well controlled, the repeated acid exposure can eventually lead to a condition known as Barrett’s esophagus, a pre-cancerous condition.

CREST syndrome - Wikipedia CREST syndrome
CREST syndrome
Contents
Signs and symptoms
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
Other
Cause
Diagnosis
Treatment
Epidemiology
History
See also
References
External links
 The number of telangiectasias and the sites involved tend to increase over time. Other
Other symptoms of CREST syndrome can be exhaustion, weakness, difficulties with breathing, pain in hands and feet, dizziness and badly healing wounds. Patients with lcSSc commonly induce pulmonary artery hypertension which may result in cor pulmonale ( heart failure due to increased pulmonary artery pressure). Cause
Crest syndrome involves the production of autoimmune anti-nuclear and anti-centromere antibodies, though their cause is not currently understood. There is no known infectious cause. Diagnosis
CREST is not easily diagnosed as it closely mimics symptoms of other connective tissue and autoimmune diseases. Diagnoses are usually given when a patient presents two or more of the five major clinical symptoms. Additionally, blood exams can be given to test for a positive ANAs and ACAs or skin biopsies can be given to help confirm a diagnosis. Treatment
Disease progression may be slowed with immunosuppressives and other medications, and esophageal reflux, pulmonary hypertension and Raynaud phenomenon may benefit from symptomatic treatment. However, there is no cure for this disease as there is no cure for scleroderma in general.

CREST syndrome - Wikipedia

The number of telangiectasias and the sites involved tend to increase over time. Other
Other symptoms of CREST syndrome can be exhaustion, weakness, difficulties with breathing, pain in hands and feet, dizziness and badly healing wounds. Patients with lcSSc commonly induce pulmonary artery hypertension which may result in cor pulmonale ( heart failure due to increased pulmonary artery pressure). Cause
Crest syndrome involves the production of autoimmune anti-nuclear and anti-centromere antibodies, though their cause is not currently understood. There is no known infectious cause. Diagnosis
CREST is not easily diagnosed as it closely mimics symptoms of other connective tissue and autoimmune diseases. Diagnoses are usually given when a patient presents two or more of the five major clinical symptoms. Additionally, blood exams can be given to test for a positive ANAs and ACAs or skin biopsies can be given to help confirm a diagnosis. Treatment
Disease progression may be slowed with immunosuppressives and other medications, and esophageal reflux, pulmonary hypertension and Raynaud phenomenon may benefit from symptomatic treatment. However, there is no cure for this disease as there is no cure for scleroderma in general.

Clinical manifestations and diagnosis of systemic sclerosis (scleroderma) in adults - UpToDate Clinical manifestations and diagnosis of systemic sclerosis (scleroderma) in adults
Topic Outline
GRAPHICS
Clinical manifestations and diagnosis of systemic sclerosis (scleroderma) in adults
Author:
Section Editor:
Deputy Editor:
INTRODUCTION
 Ann Rheum Dis 2006; 65:1088. Turner R, Lipshutz W, Miller W, et al. Esophageal dysfunction in collagen disease. Am J Med Sci 1973; 265:191. Akesson A, Wollheim FA. Organ manifestations in 100 patients with progressive systemic sclerosis: a comparison between the CREST syndrome and diffuse scleroderma. Br J Rheumatol 1989;

Clinical manifestations and diagnosis of systemic sclerosis (scleroderma) in adults - UpToDate

Clinical manifestations and diagnosis of systemic sclerosis (scleroderma) in adults
Topic Outline
GRAPHICS
Clinical manifestations and diagnosis of systemic sclerosis (scleroderma) in adults
Author:
Section Editor:
Deputy Editor:
INTRODUCTION

Ann Rheum Dis 2006; 65:1088. Turner R, Lipshutz W, Miller W, et al. Esophageal dysfunction in collagen disease. Am J Med Sci 1973; 265:191. Akesson A, Wollheim FA. Organ manifestations in 100 patients with progressive systemic sclerosis: a comparison between the CREST syndrome and diffuse scleroderma. Br J Rheumatol 1989;

CREST Syndrome - Clinical Features, Diagnosis, Self-Care Tips and Treatment | medcaretips.com CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
Clinical Features
Cause of CREST Syndrome
Risk Factors
Complications
Gastrointestinal complications
Lung complications
Heart Complications
Kidney complications
Ulcers on fingers and toes
Endocrinal complications
Other complications
Diagnosis and Investigations
Clinical evaluation
Autoantibody tests
Complete blood counts
Nonspecific indicators of inflammation
Serum calcium and phosphorus levels
Renal function tests
Thyroid function tests
X-ray of extremities
Doppler ultrasonography or angiography
Electromyogram/nerve conduction velocity test
Pulmonary function tests
Electrocardiography and Holter monitoring
Upper GI endoscopy, esophageal manometry, barium swallow studies
CT scan
Skin biopsy
Self –Care Tips
Keep warm
Quit smoking
Exercise regularly
Healthy eating habits
To prevent acid reflux
Take care of your skin
Practice good oral hygiene
Treatment
Medicinal treatment
Pain relief medication
Antibiotics
Antacids
Medicines to treat dry mouth
Immunosuppressive drugs
Penicillamine
Calcinosis
Raynaud’s phenomenon
E sophageal dysfunction
Sclerodactyly
Telangiectasias
Treatment of complications
References
About Dr Surbhi Mahajan
 CREST Syndrome - Clinical Features, Diagnosis, Self-Care Tips and Treatment | medcaretips.com
You are here: Home / Health / CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
By Dr Surbhi Mahajan
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Clinical Features
Cause of CREST Syndrome
Risk Factors
Complications
Diagnosis and Investigations
Self –Care Tips
Treatment
References
CREST syndrome is a limited or a less severe form of systemic sclerosis (lcSSc). Systemic sclerosis is a multisystem connective tissue disorder and an autoimmune disease. The acronym “CREST” refers to the five main clinical features: C alcinosis
R aynaud’s phenomenon
E sophageal dysmotility
S clerodactyly
T elangiectasia
Scleroderma is a rare connective tissue disorder. It can be divided into two forms: Localized Scleroderma (Morphea, Linear Scleroderma and Scleroderma en coup de sabre)
Systemic sclerosis. It is further classified into two types
Limited cutaneous Systemic Sclerosis (CREST syndrome)
Diffuse cutaneous Systemic Sclerosis
Systemic sclerosis is a rare disease with an incidence of 19.3 new cases per million adults per year and a prevalence of 242 cases per million adults in the United States. It is estimated that CREST syndrome accounts for about one-fourth of all cases of systemic sclerosis. However, epidemiologic studies studying the true incidence and prevalence of CREST syndrome are lacking.

CREST Syndrome - Clinical Features, Diagnosis, Self-Care Tips and Treatment | medcaretips.com
You are here: Home / Health / CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
CREST Syndrome – Clinical Features, Diagnosis, Self-Care Tips and Treatment
By Dr Surbhi Mahajan
toc
hide
toc
Clinical Features
Cause of CREST Syndrome
Risk Factors
Complications
Diagnosis and Investigations
Self –Care Tips
Treatment
References
CREST syndrome is a limited or a less severe form of systemic sclerosis (lcSSc). Systemic sclerosis is a multisystem connective tissue disorder and an autoimmune disease. The acronym “CREST” refers to the five main clinical features: C alcinosis
R aynaud’s phenomenon
E sophageal dysmotility
S clerodactyly
T elangiectasia
Scleroderma is a rare connective tissue disorder. It can be divided into two forms: Localized Scleroderma (Morphea, Linear Scleroderma and Scleroderma en coup de sabre)
Systemic sclerosis. It is further classified into two types
Limited cutaneous Systemic Sclerosis (CREST syndrome)
Diffuse cutaneous Systemic Sclerosis
Systemic sclerosis is a rare disease with an incidence of 19.3 new cases per million adults per year and a prevalence of 242 cases per million adults in the United States. It is estimated that CREST syndrome accounts for about one-fourth of all cases of systemic sclerosis. However, epidemiologic studies studying the true incidence and prevalence of CREST syndrome are lacking.

What You Need to Know About Early Scleroderma Signs What You Need to Know About Early Scleroderma Signs
What You Need to Know About Early Scleroderma Signs
Early Symptoms of Systemic Scleroderma
Early Symptoms of Scleroderma: CREST
 CREST stands for the following: Calcinosis
Raynaud's phenomenon
Esophageal dysfunction
Sclerodactyly
Telangiectasias. Calcinosis
Calcinosis is the formation of calcium deposits in the connective tissues, which can be detected by an x-ray. They are typically found on the fingers, hands, face, and trunk and on the skin above the elbows and knees. When the deposits break through the skin, painful ulcers can result. Raynaud's Phenomenon
Raynaud's phenomenon is a condition in which the small blood vessels of the hands and/or feet contract in response to cold or anxiety. As the vessels contract, the hands or feet turn white and cold, then blue. As blood flow returns, they become red. Fingertip tissues may suffer damage, leading to ulcers, scars, or gangrene. Esophageal Dysfunction
Esophageal dysfunction is impaired function of the esophagus (the tube connecting the throat and the stomach) that occurs when the smooth muscles in the esophagus lose normal movement.

What You Need to Know About Early Scleroderma Signs

What You Need to Know About Early Scleroderma Signs
What You Need to Know About Early Scleroderma Signs
Early Symptoms of Systemic Scleroderma
Early Symptoms of Scleroderma: CREST

CREST stands for the following: Calcinosis
Raynaud's phenomenon
Esophageal dysfunction
Sclerodactyly
Telangiectasias. Calcinosis
Calcinosis is the formation of calcium deposits in the connective tissues, which can be detected by an x-ray. They are typically found on the fingers, hands, face, and trunk and on the skin above the elbows and knees. When the deposits break through the skin, painful ulcers can result. Raynaud's Phenomenon
Raynaud's phenomenon is a condition in which the small blood vessels of the hands and/or feet contract in response to cold or anxiety. As the vessels contract, the hands or feet turn white and cold, then blue. As blood flow returns, they become red. Fingertip tissues may suffer damage, leading to ulcers, scars, or gangrene. Esophageal Dysfunction
Esophageal dysfunction is impaired function of the esophagus (the tube connecting the throat and the stomach) that occurs when the smooth muscles in the esophagus lose normal movement.

CREST syndrome - Wikipedia CREST syndrome
CREST syndrome
Contents
Signs and symptoms
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
Other
Cause
Diagnosis
Treatment
Epidemiology
History
See also
References
External links
 CREST syndrome - Wikipedia
CREST syndrome
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: " CREST syndrome" – news · newspapers · books · scholar · JSTOR (February 2009) ( Learn how and when to remove this template message)
Medical condition
CREST syndrome
Other names
Calcinosis-Raynaud phenomenon-esophageal involvement-sclerodactyly-telangiectasia syndrome

CREST syndrome (calcinosis and sclerodactyly)
Specialty
Rheumatology
CREST syndrome, also known as the limited cutaneous form of systemic sclerosis (lcSSc), is a multisystem connective tissue disorder. The acronym "CREST" refers to the five main features: calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. CREST syndrome is associated with detectable antibodies against centromeres (a component of the cell nucleus ), and usually spares the kidneys (a feature more common in the related condition systemic scleroderma ). If the lungs are involved, it is usually in the form of pulmonary arterial hypertension . Contents
1 Signs and symptoms
1.1 Calcinosis
1.2 Raynaud's phenomenon
1.3 Esophageal dysmotility
1.4 Sclerodactyly
1.5 Telangiectasias
1.6 Other
2 Cause
3 Diagnosis
4 Treatment
5 Epidemiology
5.1 History
6 See also
7 References
8 External links
Signs and symptoms
CREST syndrome (calcinosis and sclerodactyly)
X-rays showing calcinosis in a woman with CREST syndrome.

CREST syndrome - Wikipedia

CREST syndrome - Wikipedia
CREST syndrome
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: " CREST syndrome" – news · newspapers · books · scholar · JSTOR (February 2009) ( Learn how and when to remove this template message)
Medical condition
CREST syndrome
Other names
Calcinosis-Raynaud phenomenon-esophageal involvement-sclerodactyly-telangiectasia syndrome

CREST syndrome (calcinosis and sclerodactyly)
Specialty
Rheumatology
CREST syndrome, also known as the limited cutaneous form of systemic sclerosis (lcSSc), is a multisystem connective tissue disorder. The acronym "CREST" refers to the five main features: calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. CREST syndrome is associated with detectable antibodies against centromeres (a component of the cell nucleus ), and usually spares the kidneys (a feature more common in the related condition systemic scleroderma ). If the lungs are involved, it is usually in the form of pulmonary arterial hypertension . Contents
1 Signs and symptoms
1.1 Calcinosis
1.2 Raynaud's phenomenon
1.3 Esophageal dysmotility
1.4 Sclerodactyly
1.5 Telangiectasias
1.6 Other
2 Cause
3 Diagnosis
4 Treatment
5 Epidemiology
5.1 History
6 See also
7 References
8 External links
Signs and symptoms
CREST syndrome (calcinosis and sclerodactyly)
X-rays showing calcinosis in a woman with CREST syndrome.

CREST Disease | definition of CREST Disease by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
Mentioned in ?
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 CREST Disease | definition of CREST Disease by Medical dictionary
CREST syndrome
(redirected from CREST Disease)
CREST syndrome
one of the less severe forms of systemic scleroderma, consisting of calcinosis of the skin, raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia. When esophageal dysfunction is not prominent, it is known as CRST syndrome. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. CREST syn·drome
a variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Farlex Partner Medical Dictionary © Farlex 2012
An acronym for the pentad of clinical signs seen with a limited form of scleroderma: Calcinosis cutis
Raynaud’s phenomenon—at least a 2-phase colour change
Esophageal distal hypomotility or reflux esophagitis
Sclerodactyly or nonpitting digital edema
Telangiectasia; CREST has a slightly better prognosis than other connective tissue disorders, but has late complications—e.g., biliary cirrhosis and pulmonary hypertension
Lab Anticentromere antibodies are characteristic of CREST, but may also be seen in progressive systemic sclerosis, older women, or those with HLA-DR1
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

CREST Disease | definition of CREST Disease by Medical dictionary

CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
Mentioned in ?
Medical browser ?
Full browser ?

CREST Disease | definition of CREST Disease by Medical dictionary
CREST syndrome
(redirected from CREST Disease)
CREST syndrome
one of the less severe forms of systemic scleroderma, consisting of calcinosis of the skin, raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia. When esophageal dysfunction is not prominent, it is known as CRST syndrome. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. CREST syn·drome
a variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Farlex Partner Medical Dictionary © Farlex 2012
An acronym for the pentad of clinical signs seen with a limited form of scleroderma: Calcinosis cutis
Raynaud’s phenomenon—at least a 2-phase colour change
Esophageal distal hypomotility or reflux esophagitis
Sclerodactyly or nonpitting digital edema
Telangiectasia; CREST has a slightly better prognosis than other connective tissue disorders, but has late complications—e.g., biliary cirrhosis and pulmonary hypertension
Lab Anticentromere antibodies are characteristic of CREST, but may also be seen in progressive systemic sclerosis, older women, or those with HLA-DR1
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

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CREST Syndrome and Scleroderma
Reviewed by Stephanie S. Gardner, MD on July 25, 2019
Some people have a type of scleroderma called CREST syndrome (or limited scleroderma). Unlike other types, which only affect the arms, legs, and face, this kind can involve your digestive tract. While less common, it can also lead to problems with your heart and lungs. The good news is that your doctor can help you manage your symptoms, prevent complications, and feel better. People with this form of the disease have at least two of the symptoms below: C alcinosis -- Painful lumps of calcium in the skin. These can happen on your fingers or other parts of your body. R aynaud's phenomenon -- White or cold skin on the hands and feet when you’re cold or stressed. It’s caused by blood flow problems. E sophageal dysfunction -- Problems swallowing and/or reflux.

CREST Syndrome and Scleroderma

CREST Syndrome and Scleroderma
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CREST Syndrome and Scleroderma

CREST Syndrome and Scleroderma
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Scleroderma Home
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Acne
Bedbugs
Cold Sores
Eczema
Fungal Infections
Hair Loss
Healthy Beauty
Lice
Psoriasis
Psoriatic Arthritis
Poison Ivy
Rosacea
Shingles
Skin Cancer
More Related Topics
Skin Problems & Treatments Guide
Skin Discolorations
Chronic Skin Conditions
Acute Skin Problems
Skin Infections
Skin Conditions Resources
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Medical Reference
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Questions & Answers
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CREST Syndrome and Scleroderma
Reviewed by Stephanie S. Gardner, MD on July 25, 2019
Some people have a type of scleroderma called CREST syndrome (or limited scleroderma). Unlike other types, which only affect the arms, legs, and face, this kind can involve your digestive tract. While less common, it can also lead to problems with your heart and lungs. The good news is that your doctor can help you manage your symptoms, prevent complications, and feel better. People with this form of the disease have at least two of the symptoms below: C alcinosis -- Painful lumps of calcium in the skin. These can happen on your fingers or other parts of your body. R aynaud's phenomenon -- White or cold skin on the hands and feet when you’re cold or stressed. It’s caused by blood flow problems. E sophageal dysfunction -- Problems swallowing and/or reflux.

CREST syndrome - Wikipedia CREST syndrome
CREST syndrome
Contents
Signs and symptoms
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
Other
Cause
Diagnosis
Treatment
Epidemiology
History
See also
References
External links
 The acronym "CREST" refers to the five main features: calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. CREST syndrome is associated with detectable antibodies against centromeres (a component of the cell nucleus ), and usually spares the kidneys (a feature more common in the related condition systemic scleroderma ). If the lungs are involved, it is usually in the form of pulmonary arterial hypertension . Contents
1 Signs and symptoms
1.1 Calcinosis
1.2 Raynaud's phenomenon
1.3 Esophageal dysmotility
1.4 Sclerodactyly
1.5 Telangiectasias
1.6 Other
2 Cause
3 Diagnosis
4 Treatment
5 Epidemiology
5.1 History
6 See also
7 References
8 External links
Signs and symptoms
CREST syndrome (calcinosis and sclerodactyly)
X-rays showing calcinosis in a woman with CREST syndrome. X-ray of subtle calcifications in CREST syndrome. Calcinosis
CREST causes thickening and tightening of the skin with deposition of calcific nodules ("calcinosis"). Raynaud's phenomenon
Raynaud's phenomenon is frequently the first manifestation of CREST/lcSSc, preceding other symptoms by years. Stress and cold temperature induce an exaggerated vasoconstriction of the small arteries, arterioles, and thermoregulatory vessels of the skin of the digits. Clinically this manifests as a white-blue-red transition in skin color.

CREST syndrome - Wikipedia

The acronym "CREST" refers to the five main features: calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. CREST syndrome is associated with detectable antibodies against centromeres (a component of the cell nucleus ), and usually spares the kidneys (a feature more common in the related condition systemic scleroderma ). If the lungs are involved, it is usually in the form of pulmonary arterial hypertension . Contents
1 Signs and symptoms
1.1 Calcinosis
1.2 Raynaud's phenomenon
1.3 Esophageal dysmotility
1.4 Sclerodactyly
1.5 Telangiectasias
1.6 Other
2 Cause
3 Diagnosis
4 Treatment
5 Epidemiology
5.1 History
6 See also
7 References
8 External links
Signs and symptoms
CREST syndrome (calcinosis and sclerodactyly)
X-rays showing calcinosis in a woman with CREST syndrome. X-ray of subtle calcifications in CREST syndrome. Calcinosis
CREST causes thickening and tightening of the skin with deposition of calcific nodules ("calcinosis"). Raynaud's phenomenon
Raynaud's phenomenon is frequently the first manifestation of CREST/lcSSc, preceding other symptoms by years. Stress and cold temperature induce an exaggerated vasoconstriction of the small arteries, arterioles, and thermoregulatory vessels of the skin of the digits. Clinically this manifests as a white-blue-red transition in skin color.

CREST Syndrome: Background, Pathophysiology, Etiology CREST Syndrome
CREST Syndrome
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 Jeanie C Yoon, MD; Chief Editor: Dirk M Elston, MD more...
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Background
CREST ( calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome is a member of the heterogeneous group of sclerodermas, and its name is an acronym for the cardinal clinical features of the syndrome. [ 1, 2]
In 1910, Thibierge and Weissenbach described the first case report of what was later called CRST (calcinosis cutis, Raynaud phenomenon, sclerodactyly, and telangiectasia) syndrome in English by Winterbauer who, in 1964, described a series of 8 patients with the features that make up the abbreviation CRST. [ 3, 4] Although he noted esophageal dysmotility in 4 of 8 patients, he did not include this feature in his original description of CRST syndrome. Frayha et al [ 5] noted the frequent occurrence of esophageal dysmotility and suggested that the acronym CREST may be more appropriate. Velayos et al [ 6] reviewed 13 patients with CREST and CRST syndromes and found the syndromes equivalent. The 1980 American College of Rheumatology Classification Criteria for Rheumatic Diseases is the most widely used system for systemic scleroderma. Because it was designed for research applications and not for clinical diagnosis, it has been criticized for its low sensitivity in identifying early disease and milder forms of systemic scleroderma such as CREST syndrome. Several authors recognized this limitation and responded by categorizing patients with scleroderma syndromes into 2 groups:

CREST Syndrome: Background, Pathophysiology, Etiology

CREST Syndrome
CREST Syndrome
Background

CREST syndrome | definition of CREST syndrome by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
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CREST syn·drome
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 CREST syndrome | definition of CREST syndrome by Medical dictionary
CREST syndrome
Also found in: Dictionary, Thesaurus, Financial, Encyclopedia. Related to CREST syndrome: Scleroderma, Raynaud's syndrome, Sjogren's syndrome
CREST syndrome
one of the less severe forms of systemic scleroderma, consisting of calcinosis of the skin, raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia. When esophageal dysfunction is not prominent, it is known as CRST syndrome. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. CREST syn·drome
a variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Farlex Partner Medical Dictionary © Farlex 2012
An acronym for the pentad of clinical signs seen with a limited form of scleroderma: Calcinosis cutis
Raynaud’s phenomenon—at least a 2-phase colour change
Esophageal distal hypomotility or reflux esophagitis
Sclerodactyly or nonpitting digital edema
Telangiectasia;

CREST syndrome | definition of CREST syndrome by Medical dictionary

CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
Mentioned in ?
References in periodicals archive ?
Medical browser ?
Full browser ?

CREST syndrome | definition of CREST syndrome by Medical dictionary
CREST syndrome
Also found in: Dictionary, Thesaurus, Financial, Encyclopedia. Related to CREST syndrome: Scleroderma, Raynaud's syndrome, Sjogren's syndrome
CREST syndrome
one of the less severe forms of systemic scleroderma, consisting of calcinosis of the skin, raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia. When esophageal dysfunction is not prominent, it is known as CRST syndrome. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. CREST syn·drome
a variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Farlex Partner Medical Dictionary © Farlex 2012
An acronym for the pentad of clinical signs seen with a limited form of scleroderma: Calcinosis cutis
Raynaud’s phenomenon—at least a 2-phase colour change
Esophageal distal hypomotility or reflux esophagitis
Sclerodactyly or nonpitting digital edema
Telangiectasia;

CREST Syndrome - What is?, Pictures, Symptoms, Treatment, Diagnosis CREST Syndrome
CREST Syndrome
Definition
Symptoms
Tight hardened skin
Raynaud’s phenomenon
Red spot marks on the skin
Lumps beneath the skin
Difficulty in swallowing
Classification
Causes of CREST Syndrome
Risk factors
Complications
Diagnosis
Blood test
Biopsy of the skin sample
Heart, lung and gastrointestinal tests
CREST Syndrome Treatment
Antibiotics
Antacids
Antihypertensive drugs
Immunosuppressive medications
Rehabilitation Therapy
References
 CREST Syndrome - What is?, Pictures, Symptoms, Treatment, Diagnosis
Home » CREST Syndrome
CREST Syndrome
Definition
Hardening of the skin in a particular region is termed as CREST syndrome. This is a subtype of scleroderma and though it affects regionally, therefore it can also called as limited scleroderma. The usual sites of development of the CREST Syndrome, include the lower part of the hands and legs. CREST Syndrome also occurs in the face and throat. Internal organs like elementary cannel and in severe condition, heart or lungs can also affect. The illustration of CREST can be described as
C – Deposition of calcium in epidermis layer and subcutaneous tissue of the skin ( calcinosis)
R – failure of muscle control (Raynaud’s phenomenon) in the affected skin and tissues and even organ like esophagus. E – Esophageal muscles become weakened and swallowing difficulty arises due to dysmotility. S – a thinning malformation of the bones of the fingers and the skin becomes thicken (Sclerodactyly). T – Enlargement of the blood vessels in the affected part of the body (telangiectasias), due to this red spots occur on the face and other affected areas. (

CREST Syndrome - What is?, Pictures, Symptoms, Treatment, Diagnosis

CREST Syndrome
CREST Syndrome
Definition
Symptoms
Tight hardened skin
Raynaud’s phenomenon
Red spot marks on the skin
Lumps beneath the skin
Difficulty in swallowing
Classification
Causes of CREST Syndrome
Risk factors
Complications
Diagnosis
Blood test
Biopsy of the skin sample
Heart, lung and gastrointestinal tests
CREST Syndrome Treatment
Antibiotics
Antacids
Antihypertensive drugs
Immunosuppressive medications
Rehabilitation Therapy
References

CREST Syndrome - What is?, Pictures, Symptoms, Treatment, Diagnosis
Home » CREST Syndrome
CREST Syndrome
Definition
Hardening of the skin in a particular region is termed as CREST syndrome. This is a subtype of scleroderma and though it affects regionally, therefore it can also called as limited scleroderma. The usual sites of development of the CREST Syndrome, include the lower part of the hands and legs. CREST Syndrome also occurs in the face and throat. Internal organs like elementary cannel and in severe condition, heart or lungs can also affect. The illustration of CREST can be described as
C – Deposition of calcium in epidermis layer and subcutaneous tissue of the skin ( calcinosis)
R – failure of muscle control (Raynaud’s phenomenon) in the affected skin and tissues and even organ like esophagus. E – Esophageal muscles become weakened and swallowing difficulty arises due to dysmotility. S – a thinning malformation of the bones of the fingers and the skin becomes thicken (Sclerodactyly). T – Enlargement of the blood vessels in the affected part of the body (telangiectasias), due to this red spots occur on the face and other affected areas. (

Esophageal motility disorder - Wikipedia Esophageal motility disorder
Esophageal motility disorder
Contents
Symptoms
Types
See also
References
External links
 The most prominent one is dysphagia . Esophageal motility disorder may be a result of CREST syndrome, referring to the five main features: calcinosis, Raynaud syndrome, esophageal dysmotility, sclerodactyly and telangiectasia. Contents
1 Symptoms
1.1 Types
2 See also
3 References
4 External links
Symptoms
There are contractions along the lower esophagus when this condition happens. These contractions prevent the passage of food. Types
Dysphagia could be for solid only or for solid and liquid. Solid dysphagia is due to obstruction such as esophageal cancer, esophageal web, or stricture. Solid plus liquid dysphagia is due to esophageal motility disorder (or dysmotility) either in the upper esophagus ( myasthenia gravis, stroke, or dermatomyositis) or lower esophagus ( systemic sclerosis, CREST syndrome, or achalasia ). If there is a food allergy causing an EMD, then physicians recommend an elimination diet. If this fails, then physicians will prescribe special types of Medication to help resolve this problem.

Esophageal motility disorder - Wikipedia

Esophageal motility disorder
Esophageal motility disorder
Contents
Symptoms
Types
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References
External links

The most prominent one is dysphagia . Esophageal motility disorder may be a result of CREST syndrome, referring to the five main features: calcinosis, Raynaud syndrome, esophageal dysmotility, sclerodactyly and telangiectasia. Contents
1 Symptoms
1.1 Types
2 See also
3 References
4 External links
Symptoms
There are contractions along the lower esophagus when this condition happens. These contractions prevent the passage of food. Types
Dysphagia could be for solid only or for solid and liquid. Solid dysphagia is due to obstruction such as esophageal cancer, esophageal web, or stricture. Solid plus liquid dysphagia is due to esophageal motility disorder (or dysmotility) either in the upper esophagus ( myasthenia gravis, stroke, or dermatomyositis) or lower esophagus ( systemic sclerosis, CREST syndrome, or achalasia ). If there is a food allergy causing an EMD, then physicians recommend an elimination diet. If this fails, then physicians will prescribe special types of Medication to help resolve this problem.

Esophageal motility disorder - Wikipedia Esophageal motility disorder
Esophageal motility disorder
Contents
Symptoms
Types
See also
References
External links
 Esophageal motility disorder - Wikipedia
Esophageal motility disorder
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

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Esophageal motility disorder
Other names
Esophageal dysmotility (ED)
Diagnostic method
Esophageal motility study
Functional Lumen Imaging Probe
Treatment
treatment depends on cause
An esophageal motility disorder ( EMD) is any medical disorder causing difficulty in swallowing, regurgitation of food and a spasm -type pain which can be brought on by an allergic reaction to certain foods. The most prominent one is dysphagia . Esophageal motility disorder may be a result of CREST syndrome, referring to the five main features: calcinosis, Raynaud syndrome, esophageal dysmotility, sclerodactyly and telangiectasia. Contents
1 Symptoms
1.1 Types
2 See also
3 References
4 External links
Symptoms
There are contractions along the lower esophagus when this condition happens. These contractions prevent the passage of food.

Esophageal motility disorder - Wikipedia
Esophageal motility disorder
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: " Esophageal motility disorder" – news · newspapers · books · scholar · JSTOR (February 2017) ( Learn how and when to remove this template message)
Esophageal motility disorder
Other names
Esophageal dysmotility (ED)
Diagnostic method
Esophageal motility study
Functional Lumen Imaging Probe
Treatment
treatment depends on cause
An esophageal motility disorder ( EMD) is any medical disorder causing difficulty in swallowing, regurgitation of food and a spasm -type pain which can be brought on by an allergic reaction to certain foods. The most prominent one is dysphagia . Esophageal motility disorder may be a result of CREST syndrome, referring to the five main features: calcinosis, Raynaud syndrome, esophageal dysmotility, sclerodactyly and telangiectasia. Contents
1 Symptoms
1.1 Types
2 See also
3 References
4 External links
Symptoms
There are contractions along the lower esophagus when this condition happens. These contractions prevent the passage of food.

CREST Syndrome - What is?, Pictures, Symptoms, Treatment, Diagnosis CREST Syndrome
CREST Syndrome
Definition
Symptoms
Tight hardened skin
Raynaud’s phenomenon
Red spot marks on the skin
Lumps beneath the skin
Difficulty in swallowing
Classification
Causes of CREST Syndrome
Risk factors
Complications
Diagnosis
Blood test
Biopsy of the skin sample
Heart, lung and gastrointestinal tests
CREST Syndrome Treatment
Antibiotics
Antacids
Antihypertensive drugs
Immunosuppressive medications
Rehabilitation Therapy
References
 These lumps may be infected and tenderness also develop. Difficulty in swallowing
In CREST syndrome, people often face swallowing difficulties, due to their problem in the esophagus. The loss of control over the esophageal muscles at the upper and lower end can cause difficulty in swallowing and let back flow the acidic content of the stomach into the esophagus. This leads to heartburn, irritation and scarring of the esophagus. ( 1,2,3,4)
Classification
In medical science, depending upon the sign and symptoms, CREST syndrome is further divided into two forms: “Pure”CREST — it means when the diagnostic reports reveled that patient have two or more than two symptoms of CREST and not associated with diffuse scleroderma or other autoimmune disease. Plus CREST – It means when the patient has CREST syndrome along with another form of scleroderma, including diffuse scleroderma or other types of autoimmune disease symptoms. In diffuse scleroderma the involved skin is not localized in a particular area and the involvement of the internal organs like the digestive system, heart, lungs and kidney. ( 2,4)
Causes of CREST Syndrome
It assumed that CREST syndrome is developed due to an autoimmune disorder, means the immune system of one’s body can act against own body. This assumption comes from the pathophysiology involved in developing the CREST Syndrome.

These lumps may be infected and tenderness also develop. Difficulty in swallowing
In CREST syndrome, people often face swallowing difficulties, due to their problem in the esophagus. The loss of control over the esophageal muscles at the upper and lower end can cause difficulty in swallowing and let back flow the acidic content of the stomach into the esophagus. This leads to heartburn, irritation and scarring of the esophagus. ( 1,2,3,4)
Classification
In medical science, depending upon the sign and symptoms, CREST syndrome is further divided into two forms: “Pure”CREST — it means when the diagnostic reports reveled that patient have two or more than two symptoms of CREST and not associated with diffuse scleroderma or other autoimmune disease. Plus CREST – It means when the patient has CREST syndrome along with another form of scleroderma, including diffuse scleroderma or other types of autoimmune disease symptoms. In diffuse scleroderma the involved skin is not localized in a particular area and the involvement of the internal organs like the digestive system, heart, lungs and kidney. ( 2,4)
Causes of CREST Syndrome
It assumed that CREST syndrome is developed due to an autoimmune disorder, means the immune system of one’s body can act against own body. This assumption comes from the pathophysiology involved in developing the CREST Syndrome.

CREST syndrome causes, signs, symptoms, diagnosis & treatment CREST syndrome
CREST syndrome
What is CREST syndrome
Is CREST syndrome fatal?
What is systemic sclerosis?
Systemic sclerosis has been subdivided into 2 main subtypes, according to the distribution of skin involvement.
Key features of systemic sclerosis
Systemic sclerosis causes
Genetic susceptibility
Triggering event
Immune pathways
Paraneoplastic systemic sclerosis
Systemic sclerosis pathophysiology
Systemic sclerosis symptoms
Cutaneous features of systemic sclerosis
Skin sclerosis
Hands
Face
Other
Rarer cutaneous features
Gastrointestinal symptoms
Upper gastrointestinal tract
Lower gastrointestinal tract
Cardiopulmonary symptoms
Renal disease
Other symptoms
Systemic sclerosis diagnosis
Investigations may include:
Systemic sclerosis treatment
General advice
Anti-fibrotic therapies
Topical therapies:
Physical therapies:
Systemic therapies:
Vasodilation
Treatment of skin manifestations
Raynaud phenomenon
Digital ulcers
Telangiectases
Calcinosis
Pruritus
Facial fat loss
Treatment of internal organ manifestations
Interstitial lung disease
Pulmonary artery hypertension
Renal disease
Gastrointestinal tract
Systemic sclerosis monitoring
Skin
Internal organs
CREST syndrome causes
Risk factors for CREST syndrome
CREST syndrome symptoms
CREST syndrome symptoms and signs include:
CREST syndrome complications
CREST syndrome diagnosis
CREST syndrome treatment
Medications
Therapy
Surgery
CREST syndrome life expectancy
MOST POPULAR
 The “R”, stands for Raynaud’s phenomenon, spasm of blood vessels in the fingers or toes in response to cold or stress. The “E” represents esophageal dysmotility, which can cause difficulty in swallowing. The “S” is for sclerodactyly, tightening of the skin causing the fingers to bend. Finally, the letter “T” is for telangiectasia, dilated vessels on the skin of the fingers, face, or inside of the mouth. Usually only 2 of the 5 symptoms of the CREST syndrome is necessary to be diagnosed with limited scleroderma. The skin changes associated with limited scleroderma typically occur only in the lower arms and legs, below the elbows and knees, and sometimes affect the face and neck. Limited scleroderma can also affect your digestive tract, heart, lungs or kidneys. The symptoms involved in CREST syndrome are associated with the generalized form of the disease systemic sclerosis (scleroderma). CREST is an acronym for the clinical features that are seen in a patient with this disease. (C) – Calcinosis:

The “R”, stands for Raynaud’s phenomenon, spasm of blood vessels in the fingers or toes in response to cold or stress. The “E” represents esophageal dysmotility, which can cause difficulty in swallowing. The “S” is for sclerodactyly, tightening of the skin causing the fingers to bend. Finally, the letter “T” is for telangiectasia, dilated vessels on the skin of the fingers, face, or inside of the mouth. Usually only 2 of the 5 symptoms of the CREST syndrome is necessary to be diagnosed with limited scleroderma. The skin changes associated with limited scleroderma typically occur only in the lower arms and legs, below the elbows and knees, and sometimes affect the face and neck. Limited scleroderma can also affect your digestive tract, heart, lungs or kidneys. The symptoms involved in CREST syndrome are associated with the generalized form of the disease systemic sclerosis (scleroderma). CREST is an acronym for the clinical features that are seen in a patient with this disease. (C) – Calcinosis:

CREST syndrome causes, signs, symptoms, diagnosis & treatment CREST syndrome
CREST syndrome
What is CREST syndrome
Is CREST syndrome fatal?
What is systemic sclerosis?
Systemic sclerosis has been subdivided into 2 main subtypes, according to the distribution of skin involvement.
Key features of systemic sclerosis
Systemic sclerosis causes
Genetic susceptibility
Triggering event
Immune pathways
Paraneoplastic systemic sclerosis
Systemic sclerosis pathophysiology
Systemic sclerosis symptoms
Cutaneous features of systemic sclerosis
Skin sclerosis
Hands
Face
Other
Rarer cutaneous features
Gastrointestinal symptoms
Upper gastrointestinal tract
Lower gastrointestinal tract
Cardiopulmonary symptoms
Renal disease
Other symptoms
Systemic sclerosis diagnosis
Investigations may include:
Systemic sclerosis treatment
General advice
Anti-fibrotic therapies
Topical therapies:
Physical therapies:
Systemic therapies:
Vasodilation
Treatment of skin manifestations
Raynaud phenomenon
Digital ulcers
Telangiectases
Calcinosis
Pruritus
Facial fat loss
Treatment of internal organ manifestations
Interstitial lung disease
Pulmonary artery hypertension
Renal disease
Gastrointestinal tract
Systemic sclerosis monitoring
Skin
Internal organs
CREST syndrome causes
Risk factors for CREST syndrome
CREST syndrome symptoms
CREST syndrome symptoms and signs include:
CREST syndrome complications
CREST syndrome diagnosis
CREST syndrome treatment
Medications
Therapy
Surgery
CREST syndrome life expectancy
MOST POPULAR
 CREST syndrome causes, signs, symptoms, diagnosis & treatment
CREST syndrome
Contents [ hide]
What is CREST syndrome
Is CREST syndrome fatal? What is systemic sclerosis? Systemic sclerosis causes
Systemic sclerosis pathophysiology
Systemic sclerosis symptoms
Cutaneous features of systemic sclerosis
Gastrointestinal symptoms
Cardiopulmonary symptoms
Renal disease
Other symptoms
Systemic sclerosis diagnosis
Systemic sclerosis treatment
General advice
Anti-fibrotic therapies
Treatment of skin manifestations
Treatment of internal organ manifestations
Systemic sclerosis monitoring
CREST syndrome causes
Risk factors for CREST syndrome
CREST syndrome symptoms
CREST syndrome complications
CREST syndrome diagnosis
CREST syndrome treatment
Medications
Therapy
Surgery
CREST syndrome life expectancy
What is CREST syndrome
CREST syndrome is now called limited scleroderma, is a widespread connective tissue disease characterized by changes in the skin, blood vessels, skeletal muscles, and internal organs 1). CREST is an acronym for the clinical features that are seen in a patient with limited scleroderma or limited cutaneous systemic sclerosis. The “C” stands for calcinosis, where calcium deposits form under the skin on the fingers or other areas of the body. The “R”, stands for Raynaud’s phenomenon, spasm of blood vessels in the fingers or toes in response to cold or stress. The “E” represents esophageal dysmotility, which can cause difficulty in swallowing. The “S” is for sclerodactyly, tightening of the skin causing the fingers to bend. Finally, the letter “T” is for telangiectasia, dilated vessels on the skin of the fingers, face, or inside of the mouth. Usually only 2 of the 5 symptoms of the CREST syndrome is necessary to be diagnosed with limited scleroderma.

Definition of CREST syndrome Medical Definition of CREST syndrome
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 CREST syndrome: A limited form of scleroderma, a disease of connective tissue that involves the formation of scar tissue (fibrosis) in the skin and sometimes also in other organs of the body. ' CREST' is an acronym for Calcinosis (the formation of tiny deposits of calcium in the skin), Raynaud's phenomenon (spasm of the tiny artery vessels that supply blood to the fingers, toes, nose, tongue, or ears), Esophagial dysmotility (esophageal involvement by the scleroderma ), Sclerodactyly (localized thickening and tightness of the skin of the fingers or toes), and Telangiectasias (dilated capillaries that form tiny red areas, frequently on the face and hands and in the mouth, behind the lips). CONTINUE SCROLLING OR CLICK HERE
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Definition of CREST syndrome

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Medical Definition of CREST syndrome
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CREST syndrome: A limited form of scleroderma, a disease of connective tissue that involves the formation of scar tissue (fibrosis) in the skin and sometimes also in other organs of the body. ' CREST' is an acronym for Calcinosis (the formation of tiny deposits of calcium in the skin), Raynaud's phenomenon (spasm of the tiny artery vessels that supply blood to the fingers, toes, nose, tongue, or ears), Esophagial dysmotility (esophageal involvement by the scleroderma ), Sclerodactyly (localized thickening and tightness of the skin of the fingers or toes), and Telangiectasias (dilated capillaries that form tiny red areas, frequently on the face and hands and in the mouth, behind the lips). CONTINUE SCROLLING OR CLICK HERE
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What Is Rheumatoid Arthritis (RA)? Symptoms, Treatment, Diagnosis See Slideshow
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CREST syndrome
Overview
The symptoms involved in CREST syndrome are associated with the generalized form of the disease Systemic sclerosis (scleroderma). CREST is an acronym for the clinical features that are seen in a patient with this disease. The "C" stands for calcinosis, where calcium deposits form under the skin on the fingers or other areas of the body. The "R", stands for Raynaud's phenomenon, spasm of blood vessels in the fingers or toes in response to cold or stress. The "E" represents esophageal dysmotility, which can cause difficulty in swallowing. The "S" is for sclerodactyly, tightening of the skin causing the fingers to bend. Finally, the letter "T" is for telangiectasia, dilated vessels on the skin of the fingers, face, or inside of the mouth.

CREST syndrome: MedlinePlus Medical Encyclopedia Image

CREST syndrome
COVID-19 Information
CREST syndrome
Overview
Was this page helpful?

CREST syndrome: MedlinePlus Medical Encyclopedia Image
COVID-19 Information
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Get the latest public health information from CDC
Get the latest research information from NIH | Español
Learn more about COVID-19 and you from HHS
You Are Here: Home →
Medical Encyclopedia →
CREST syndrome
URL of this page: //medlineplus.gov/ency/imagepages/19507.htm
CREST syndrome
Overview
The symptoms involved in CREST syndrome are associated with the generalized form of the disease Systemic sclerosis (scleroderma). CREST is an acronym for the clinical features that are seen in a patient with this disease. The "C" stands for calcinosis, where calcium deposits form under the skin on the fingers or other areas of the body. The "R", stands for Raynaud's phenomenon, spasm of blood vessels in the fingers or toes in response to cold or stress. The "E" represents esophageal dysmotility, which can cause difficulty in swallowing. The "S" is for sclerodactyly, tightening of the skin causing the fingers to bend. Finally, the letter "T" is for telangiectasia, dilated vessels on the skin of the fingers, face, or inside of the mouth.

What Are the Symptoms of CREST Syndrome? What Are the Symptoms of CREST Syndrome?
What Are the Symptoms of CREST Syndrome?
What Is CREST Syndrome?
What Are Signs and Symptoms of CREST Syndrome?
What Causes CREST Syndrome?
How Do Doctors Diagnose CREST Syndrome?
What Is the Treatment for CREST Syndrome?
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What Are Complications of CREST Syndrome?
What Is the Life Expectancy for CREST Syndrome?
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 Imaging studies used to diagnose CREST syndrome (limited scleroderma) include the following: Calcinosis
X-rays
Computed tomography (CT) scans
Bone scans (skeletal scintigraphy with diphosphate compounds)
Videodermatoscopy
Raynaud phenomenon
Doppler ultrasound
Angiography
Esophageal dysmotility
Radiologic barium studies with attention to the esophagus (cine-esophagram)
Fluoroscopy
Radionuclide scanning
Esophageal manometry
Twenty-four-hour pH monitoring
Esophagogastroduodenoscopy
Biopsy (for Barrett's esophagitis or adenocarcinoma)
Cough or fatigue
Transthoracic echocardiography
Chest X-rays
What Is the Treatment for CREST Syndrome? Treatment for CREST syndrome (limited scleroderma) includes the following: Calcinosis
Simple surgical management, including curettage
Intralesional corticosteroid therapy
Probenecid
Low-dose warfarin (in selected patients with early or mild disease)
Aluminum hydroxide
Low-dose colchicine for local inflammation
Raynaud's phenomenon
Use of good hand and body warming techniques to keep core body and hand temperature elevated
Stop smoking. Calcium channel blockers
Topical nitroglycerin and topical glyceryl trinitrate
Prostaglandin E1, prostacyclin I2, and iloprost (a prostacyclin-I2 analogue) (not FDA approved for this use)
Intravenous infusions of prostacyclin I2 ( epoprostenol) or prostaglandin E1 ( alprostadil)
Oral or intravenous iloprost
Esophageal dysmotility
Behavior changes such as weight loss, elevating the head of the bed, reducing intake of food and drink triggers ( caffeine, alcohol, chocolate ), quitting smoking, avoiding eating just before lying down, eating small meals
H2 blockers (e.g., ranitidine, famotidine, nizatidine)
Proton-pump inhibitors (if erosive esophagitis is present)
Motility-promoting agents such as cisapride
Esophageal dilatation
Sclerodactyly
Corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), D- penicillamine, IFN-gamma, cyclosporine, and cytostatic drugs have been used with limited success in scleroderma. Skin involvement is usually not severe so it may not need treatment. Telangiectasia
Pulsed-dye laser treatment for facial telangiectasia
Medical treatment with estrogen- progesterone or desmopressin, laser ablation, sclerotherapy for symptomatic gastrointestinal telangiectasia
Depression and anxiety affect a large number of patients so these issues may need treatment. QUESTION
The term arthritis refers to stiffness in the joints. See Answer
What Are Complications of CREST Syndrome? Share Your Story
Complications of CREST syndrome (limited scleroderma) include
renal (kidney) involvement and an
increased risk of cancer, particularly lung cancer.

What Are the Symptoms of CREST Syndrome?

What Are the Symptoms of CREST Syndrome?
What Are the Symptoms of CREST Syndrome?
What Is CREST Syndrome?
What Are Signs and Symptoms of CREST Syndrome?
What Causes CREST Syndrome?
How Do Doctors Diagnose CREST Syndrome?
What Is the Treatment for CREST Syndrome?
QUESTION
What Are Complications of CREST Syndrome?
What Is the Life Expectancy for CREST Syndrome?
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Definition of CREST syndrome Medical Definition of CREST syndrome
Medical Definition of CREST syndrome
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 Definition of CREST syndrome
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Medical Definition of CREST syndrome
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©1996-2021 MedicineNet, Inc. All rights reserved. Terms of Use. MedicineNet does not provide medical advice, diagnosis or treatment. See additional information. CREST syndrome: A limited form of scleroderma, a disease of connective tissue that involves the formation of scar tissue (fibrosis) in the skin and sometimes also in other organs of the body. ' CREST' is an acronym for Calcinosis (the formation of tiny deposits of calcium in the skin), Raynaud's phenomenon (spasm of the tiny artery vessels that supply blood to the fingers, toes, nose, tongue, or ears), Esophagial dysmotility (esophageal involvement by the scleroderma ), Sclerodactyly (localized thickening and tightness of the skin of the fingers or toes), and Telangiectasias (dilated capillaries that form tiny red areas, frequently on the face and hands and in the mouth, behind the lips). CONTINUE SCROLLING OR CLICK HERE
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Definition of CREST syndrome

Definition of CREST syndrome
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©1996-2021 MedicineNet, Inc. All rights reserved. Terms of Use. MedicineNet does not provide medical advice, diagnosis or treatment. See additional information. CREST syndrome: A limited form of scleroderma, a disease of connective tissue that involves the formation of scar tissue (fibrosis) in the skin and sometimes also in other organs of the body. ' CREST' is an acronym for Calcinosis (the formation of tiny deposits of calcium in the skin), Raynaud's phenomenon (spasm of the tiny artery vessels that supply blood to the fingers, toes, nose, tongue, or ears), Esophagial dysmotility (esophageal involvement by the scleroderma ), Sclerodactyly (localized thickening and tightness of the skin of the fingers or toes), and Telangiectasias (dilated capillaries that form tiny red areas, frequently on the face and hands and in the mouth, behind the lips). CONTINUE SCROLLING OR CLICK HERE
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The Different Types of Scleroderma (Systemic Sclerosis) The Different Types of Scleroderma (Systemic Sclerosis)
The Different Types of Scleroderma (Systemic Sclerosis)
Localized Scleroderma
Systemic Sclerosis
CREST Syndrome
Limited Scleroderma
Diffuse Scleroderma
Systemic Sclerosis Sine Scleroderma
A Word From Verywell
 CREST Syndrome
Systemic sclerosis often involves a group of symptoms known as CREST syndrome. Features of CREST syndrome: Calcinosis: Formation of calcium deposits in the connective tissue
Raynaud's phenomenon: The blood vessels of the hands or feet contract in response to triggers, like cold or anxiety
Esophageal dysfunction: Impaired function of esophageal smooth muscles
Sclerodactyly: Thick and tight skin on your fingers due to deposits of excess collagen within skin layers
Telangiectasias: Small red spots on the hands and face caused by swelling of tiny blood vessels
A late complication of CREST can be elevated pulmonary artery pressure. Monitoring for this condition is recommended, typically by pulmonary function testing and/or echocardiogram. Limited Scleroderma
Systemic sclerosis is divided into two categories, limited and diffuse.

The Different Types of Scleroderma (Systemic Sclerosis)

The Different Types of Scleroderma (Systemic Sclerosis)
The Different Types of Scleroderma (Systemic Sclerosis)
Localized Scleroderma
Systemic Sclerosis
CREST Syndrome
Limited Scleroderma
Diffuse Scleroderma
Systemic Sclerosis Sine Scleroderma
A Word From Verywell

CREST Syndrome
Systemic sclerosis often involves a group of symptoms known as CREST syndrome. Features of CREST syndrome: Calcinosis: Formation of calcium deposits in the connective tissue
Raynaud's phenomenon: The blood vessels of the hands or feet contract in response to triggers, like cold or anxiety
Esophageal dysfunction: Impaired function of esophageal smooth muscles
Sclerodactyly: Thick and tight skin on your fingers due to deposits of excess collagen within skin layers
Telangiectasias: Small red spots on the hands and face caused by swelling of tiny blood vessels
A late complication of CREST can be elevated pulmonary artery pressure. Monitoring for this condition is recommended, typically by pulmonary function testing and/or echocardiogram. Limited Scleroderma
Systemic sclerosis is divided into two categories, limited and diffuse.

What Are the Symptoms of CREST Syndrome? What Are the Symptoms of CREST Syndrome?
What Are the Symptoms of CREST Syndrome?
What Is CREST Syndrome?
What Are Signs and Symptoms of CREST Syndrome?
What Causes CREST Syndrome?
How Do Doctors Diagnose CREST Syndrome?
What Is the Treatment for CREST Syndrome?
QUESTION
What Are Complications of CREST Syndrome?
What Is the Life Expectancy for CREST Syndrome?
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 Risk factors for developing CREST syndrome include the following: Genetics
Female gender
Ethnicity: It affects blacks and native Americans more than whites. Environmental factors
Exposure to certain toxins such as polyvinyl chloride, benzene, silica, trichloroethylene, synthetic adhesives, solvents (including chlorinated solvents, aromatic solvents, white spirit, toluene, trichloroethylene, formaldehyde, vinyl chloride, and cleaning products)
L-tryptophan and rapeseed oil exposure
Certain occupations including female teachers, female textile workers, and construction workers
Use of vibrating tools
How Do Doctors Diagnose CREST Syndrome? Tests used to diagnose CREST syndrome (limited scleroderma) include
ANAs,
anticentromere antibodies,
serum calcium and phosphorus levels, and
thyrotropin level. Imaging studies used to diagnose CREST syndrome (limited scleroderma) include the following: Calcinosis
X-rays
Computed tomography (CT) scans
Bone scans (skeletal scintigraphy with diphosphate compounds)
Videodermatoscopy
Raynaud phenomenon
Doppler ultrasound
Angiography
Esophageal dysmotility
Radiologic barium studies with attention to the esophagus (cine-esophagram)
Fluoroscopy
Radionuclide scanning
Esophageal manometry
Twenty-four-hour pH monitoring
Esophagogastroduodenoscopy
Biopsy (for Barrett's esophagitis or adenocarcinoma)
Cough or fatigue
Transthoracic echocardiography
Chest X-rays
What Is the Treatment for CREST Syndrome? Treatment for CREST syndrome (limited scleroderma) includes the following: Calcinosis
Simple surgical management, including curettage
Intralesional corticosteroid therapy
Probenecid
Low-dose warfarin (in selected patients with early or mild disease)
Aluminum hydroxide
Low-dose colchicine for local inflammation
Raynaud's phenomenon
Use of good hand and body warming techniques to keep core body and hand temperature elevated
Stop smoking. Calcium channel blockers
Topical nitroglycerin and topical glyceryl trinitrate
Prostaglandin E1, prostacyclin I2, and iloprost (a prostacyclin-I2 analogue) (not FDA approved for this use)
Intravenous infusions of prostacyclin I2 ( epoprostenol) or prostaglandin E1 ( alprostadil)
Oral or intravenous iloprost
Esophageal dysmotility
Behavior changes such as weight loss, elevating the head of the bed, reducing intake of food and drink triggers ( caffeine, alcohol, chocolate ), quitting smoking, avoiding eating just before lying down, eating small meals
H2 blockers (e.g., ranitidine, famotidine, nizatidine)
Proton-pump inhibitors (if erosive esophagitis is present)
Motility-promoting agents such as cisapride
Esophageal dilatation
Sclerodactyly
Corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), D- penicillamine, IFN-gamma, cyclosporine, and cytostatic drugs have been used with limited success in scleroderma.

CREST Syndrome: Background, Pathophysiology, Etiology CREST Syndrome
CREST Syndrome
Background
 Frayha et al [ 5] noted the frequent occurrence of esophageal dysmotility and suggested that the acronym CREST may be more appropriate. Velayos et al [ 6] reviewed 13 patients with CREST and CRST syndromes and found the syndromes equivalent. The 1980 American College of Rheumatology Classification Criteria for Rheumatic Diseases is the most widely used system for systemic scleroderma. Because it was designed for research applications and not for clinical diagnosis, it has been criticized for its low sensitivity in identifying early disease and milder forms of systemic scleroderma such as CREST syndrome. Several authors recognized this limitation and responded by categorizing patients with scleroderma syndromes into 2 groups: those with diffuse cutaneous scleroderma and those with a limited form of scleroderma. [ 7, 8, 9]
Others have shown that visceral involvement, poorer prognosis, and higher mortality are all more common in patients with diffuse disease. [ 10, 11, 12, 13] Several new classification systems may better categorize the wide spectrum of systemic scleroderma. In 2004, Nadashkevich et al [ 14] proposed the classification criteria (1) autoantibodies to centromere proteins, Scl-70 (topo I) and fibrillarin; ( 2) bibasilar pulmonary fibrosis; (

Frayha et al [ 5] noted the frequent occurrence of esophageal dysmotility and suggested that the acronym CREST may be more appropriate. Velayos et al [ 6] reviewed 13 patients with CREST and CRST syndromes and found the syndromes equivalent. The 1980 American College of Rheumatology Classification Criteria for Rheumatic Diseases is the most widely used system for systemic scleroderma. Because it was designed for research applications and not for clinical diagnosis, it has been criticized for its low sensitivity in identifying early disease and milder forms of systemic scleroderma such as CREST syndrome. Several authors recognized this limitation and responded by categorizing patients with scleroderma syndromes into 2 groups: those with diffuse cutaneous scleroderma and those with a limited form of scleroderma. [ 7, 8, 9]
Others have shown that visceral involvement, poorer prognosis, and higher mortality are all more common in patients with diffuse disease. [ 10, 11, 12, 13] Several new classification systems may better categorize the wide spectrum of systemic scleroderma. In 2004, Nadashkevich et al [ 14] proposed the classification criteria (1) autoantibodies to centromere proteins, Scl-70 (topo I) and fibrillarin; ( 2) bibasilar pulmonary fibrosis; (

CREST Syndrome - What is?, Pictures, Symptoms, Treatment, Diagnosis CREST Syndrome
CREST Syndrome
Definition
Symptoms
Tight hardened skin
Raynaud’s phenomenon
Red spot marks on the skin
Lumps beneath the skin
Difficulty in swallowing
Classification
Causes of CREST Syndrome
Risk factors
Complications
Diagnosis
Blood test
Biopsy of the skin sample
Heart, lung and gastrointestinal tests
CREST Syndrome Treatment
Antibiotics
Antacids
Antihypertensive drugs
Immunosuppressive medications
Rehabilitation Therapy
References
 Due to esophageal impairment can cause acid reflux and that able to obliterate tooth enamel, and alteration of the gum muscles may lead to loosen tooth hold. In severe CREST syndrome patient also complain about dry eyes and mouth. ( 1)
Diagnosis
The CREST syndrome diagnosis is based on symptomatic examination and medical history analysis. In addition following tests are also conducted for determination of the underlying cause and severity judgment: Blood test
Analysis of the involve antibodies is assessed through a blood test, though this is not provided confirmatory result, as every individual has not contain the suspected identified antibodies. Biopsy of the skin sample
Doctors can take a small skin sample of the affected area, for biopsy test. This may not helpful to determine the CREST symptom, but it confirms that malignancy is not involved in the alteration of the skin structure. Heart, lung and gastrointestinal tests
The different test related to heart, lungs and gastrointestinal tract also conduct to estimate the internal organ involvement and severity of the CREST syndrome. ( 1)
CREST Syndrome Treatment
CREST syndrome is incurable condition, the available treatment options help to reduce the symptomatic manifestations and restrict probable complications. Pharmaco-therapies
Antibiotics
Topical antibiotics are prescribed to apply the affected area, if the superficial skin surface become infected.

Due to esophageal impairment can cause acid reflux and that able to obliterate tooth enamel, and alteration of the gum muscles may lead to loosen tooth hold. In severe CREST syndrome patient also complain about dry eyes and mouth. ( 1)
Diagnosis
The CREST syndrome diagnosis is based on symptomatic examination and medical history analysis. In addition following tests are also conducted for determination of the underlying cause and severity judgment: Blood test
Analysis of the involve antibodies is assessed through a blood test, though this is not provided confirmatory result, as every individual has not contain the suspected identified antibodies. Biopsy of the skin sample
Doctors can take a small skin sample of the affected area, for biopsy test. This may not helpful to determine the CREST symptom, but it confirms that malignancy is not involved in the alteration of the skin structure. Heart, lung and gastrointestinal tests
The different test related to heart, lungs and gastrointestinal tract also conduct to estimate the internal organ involvement and severity of the CREST syndrome. ( 1)
CREST Syndrome Treatment
CREST syndrome is incurable condition, the available treatment options help to reduce the symptomatic manifestations and restrict probable complications. Pharmaco-therapies
Antibiotics
Topical antibiotics are prescribed to apply the affected area, if the superficial skin surface become infected.

CREST Syndrome: Background, Pathophysiology, Etiology CREST Syndrome
CREST Syndrome
Background
 CREST Syndrome: Background, Pathophysiology, Etiology
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Drugs & Diseases > Dermatology
CREST Syndrome
Updated: Oct 05, 2020
Author: Jeanie C Yoon, MD; Chief Editor: Dirk M Elston, MD more...
Sections
CREST Syndrome
Sections CREST Syndrome
Overview
Background
Pathophysiology
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Overview
Background
CREST ( calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome is a member of the heterogeneous group of sclerodermas, and its name is an acronym for the cardinal clinical features of the syndrome. [ 1, 2]
In 1910, Thibierge and Weissenbach described the first case report of what was later called CRST (calcinosis cutis, Raynaud phenomenon, sclerodactyly, and telangiectasia) syndrome in English by Winterbauer who, in 1964, described a series of 8 patients with the features that make up the abbreviation CRST. [ 3, 4] Although he noted esophageal dysmotility in 4 of 8 patients, he did not include this feature in his original description of CRST syndrome.

Scleroderma Symptoms - Scleroderma Education Project Scleroderma Symptoms
Scleroderma Symptoms
Clinical Features – General
Raynaud’s Phenomenon
Skin Changes
Telangiectasias
Calcinosis
Puffy Fingers
Miscellaneous
Musculoskeletal (Muscles and Joints)
Pulmonary (Lungs)
Gastrointestinal
Cardiac (Heart)
Renal (Kidney)
Sexual Dysfunction
Other Symptoms
 Many patients with limited scleroderma eventually develop a cluster of symptoms that are listed using the acronym CREST. CREST is an acronym for calcinosis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly and telangiectasia. Calcinosis is the abnormal accumulation of calcium salts under the skin and in many other organs. It presents as small, localized, hard masses on fingers, forearms, or other pressure points. Raynaud’s phenomenon is characterized by the intermittent loss of blood to various parts of the body – particularly the fingers, toes, nose, and/or ears after exposure to cold and causes tingling sensations, numbness, and/or pain. This can result in ulceration and necrosis of the fingertips and in some severe cases, lead to amputation of the affected digits. Dysfunction of the lower esophagus results in chronic heartburn and possible esophageal scarring. If the heartburn symptoms are not well controlled, the repeated acid exposure can eventually lead to a condition known as Barrett’s esophagus, a pre-cancerous condition. The esophagus may eventually have areas that are narrowed and swallowing may become difficult. The small intestine may also lose the ability to push food through to the large intestine leading to malabsorption and increased bacterial growth in the small intestine.

Scleroderma Symptoms - Scleroderma Education Project

Scleroderma Symptoms
Scleroderma Symptoms
Clinical Features – General
Raynaud’s Phenomenon
Skin Changes
Telangiectasias
Calcinosis
Puffy Fingers
Miscellaneous
Musculoskeletal (Muscles and Joints)
Pulmonary (Lungs)
Gastrointestinal
Cardiac (Heart)
Renal (Kidney)
Sexual Dysfunction
Other Symptoms

Many patients with limited scleroderma eventually develop a cluster of symptoms that are listed using the acronym CREST. CREST is an acronym for calcinosis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly and telangiectasia. Calcinosis is the abnormal accumulation of calcium salts under the skin and in many other organs. It presents as small, localized, hard masses on fingers, forearms, or other pressure points. Raynaud’s phenomenon is characterized by the intermittent loss of blood to various parts of the body – particularly the fingers, toes, nose, and/or ears after exposure to cold and causes tingling sensations, numbness, and/or pain. This can result in ulceration and necrosis of the fingertips and in some severe cases, lead to amputation of the affected digits. Dysfunction of the lower esophagus results in chronic heartburn and possible esophageal scarring. If the heartburn symptoms are not well controlled, the repeated acid exposure can eventually lead to a condition known as Barrett’s esophagus, a pre-cancerous condition. The esophagus may eventually have areas that are narrowed and swallowing may become difficult. The small intestine may also lose the ability to push food through to the large intestine leading to malabsorption and increased bacterial growth in the small intestine.

Types of Scleroderma : CREST Syndrome : Diffuse Scleroderma Types of Scleroderma
Types of Scleroderma
The classification of scleroderma by skin manifestations:
Limited Scleroderma – CREST Syndrome
Diffuse Scleroderma
Use of this Site
 Every person with scleroderma is different and has a different pattern of symptoms. The CREST syndrome is a type of limited scleroderma. CREST stands for the following: C
(calcinosis) is for the calcium deposits under the skin and in tissues. R
stands for Raynaud’s phenomenon. E
is for esophageal dysmotility. This causes heartburn, which is often experienced by CREST patients. S
is for sclerodactyly; that means thick skin on the fingers. T
is for telangiectasias, which are enlarged blood vessels.

Types of Scleroderma : CREST Syndrome : Diffuse Scleroderma

Types of Scleroderma
Types of Scleroderma
The classification of scleroderma by skin manifestations:
Limited Scleroderma – CREST Syndrome
Diffuse Scleroderma
Use of this Site

Every person with scleroderma is different and has a different pattern of symptoms. The CREST syndrome is a type of limited scleroderma. CREST stands for the following: C
(calcinosis) is for the calcium deposits under the skin and in tissues. R
stands for Raynaud’s phenomenon. E
is for esophageal dysmotility. This causes heartburn, which is often experienced by CREST patients. S
is for sclerodactyly; that means thick skin on the fingers. T
is for telangiectasias, which are enlarged blood vessels.

CREST syndrome | definition of CREST syndrome by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
Mentioned in ?
References in periodicals archive ?
Medical browser ?
Full browser ?
 Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. CREST syn·drome
a variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Farlex Partner Medical Dictionary © Farlex 2012
An acronym for the pentad of clinical signs seen with a limited form of scleroderma: Calcinosis cutis
Raynaud’s phenomenon—at least a 2-phase colour change
Esophageal distal hypomotility or reflux esophagitis
Sclerodactyly or nonpitting digital edema
Telangiectasia; CREST has a slightly better prognosis than other connective tissue disorders, but has late complications—e.g., biliary cirrhosis and pulmonary hypertension
Lab Anticentromere antibodies are characteristic of CREST, but may also be seen in progressive systemic sclerosis, older women, or those with HLA-DR1
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved. CREST syn·drome
( krest sin'drōm)
An acronymic designation for a variant of scleroderma characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Health Professions and Nursing © Farlex 2012
CREST syndrome
Acronym for a connective tissue disorder, related to progressive systemic sclerosis, but limited to CALCINOSIS, RAYNAUD'S PHENOMENON, oesophageal involvement, hardness of the fingers (Sclerodactyly) and dilated skin blood vessels ( TELANGIECTASIA ).

Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. CREST syn·drome
a variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Farlex Partner Medical Dictionary © Farlex 2012
An acronym for the pentad of clinical signs seen with a limited form of scleroderma: Calcinosis cutis
Raynaud’s phenomenon—at least a 2-phase colour change
Esophageal distal hypomotility or reflux esophagitis
Sclerodactyly or nonpitting digital edema
Telangiectasia; CREST has a slightly better prognosis than other connective tissue disorders, but has late complications—e.g., biliary cirrhosis and pulmonary hypertension
Lab Anticentromere antibodies are characteristic of CREST, but may also be seen in progressive systemic sclerosis, older women, or those with HLA-DR1
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved. CREST syn·drome
( krest sin'drōm)
An acronymic designation for a variant of scleroderma characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Health Professions and Nursing © Farlex 2012
CREST syndrome
Acronym for a connective tissue disorder, related to progressive systemic sclerosis, but limited to CALCINOSIS, RAYNAUD'S PHENOMENON, oesophageal involvement, hardness of the fingers (Sclerodactyly) and dilated skin blood vessels ( TELANGIECTASIA ).

Esophageal motility disorder - Wikipedia Esophageal motility disorder
Esophageal motility disorder
Contents
Symptoms
Types
See also
References
External links
 Types
Dysphagia could be for solid only or for solid and liquid. Solid dysphagia is due to obstruction such as esophageal cancer, esophageal web, or stricture. Solid plus liquid dysphagia is due to esophageal motility disorder (or dysmotility) either in the upper esophagus ( myasthenia gravis, stroke, or dermatomyositis) or lower esophagus ( systemic sclerosis, CREST syndrome, or achalasia ). If there is a food allergy causing an EMD, then physicians recommend an elimination diet. If this fails, then physicians will prescribe special types of Medication to help resolve this problem. See also
Esophageal disease
Esophageal motility study
Esophageal spasm
GERD (Gastroesophageal Reflux Disease)
Nutcracker esophagus
Systemic sclerosis
Esophageal food bolus obstruction
Dysphagia
Functional Lumen Imaging Probe
References
^ Winterbauer RH (1964). " Multiple telangiectasia, Raynaud's phenomenon, sclerodactyly, and subcutaneous calcinosis: a syndrome mimicking hereditary hemorrhagic telangiectasia". Bulletin of the Johns Hopkins Hospital 114: 31–83.

Types
Dysphagia could be for solid only or for solid and liquid. Solid dysphagia is due to obstruction such as esophageal cancer, esophageal web, or stricture. Solid plus liquid dysphagia is due to esophageal motility disorder (or dysmotility) either in the upper esophagus ( myasthenia gravis, stroke, or dermatomyositis) or lower esophagus ( systemic sclerosis, CREST syndrome, or achalasia ). If there is a food allergy causing an EMD, then physicians recommend an elimination diet. If this fails, then physicians will prescribe special types of Medication to help resolve this problem. See also
Esophageal disease
Esophageal motility study
Esophageal spasm
GERD (Gastroesophageal Reflux Disease)
Nutcracker esophagus
Systemic sclerosis
Esophageal food bolus obstruction
Dysphagia
Functional Lumen Imaging Probe
References
^ Winterbauer RH (1964). " Multiple telangiectasia, Raynaud's phenomenon, sclerodactyly, and subcutaneous calcinosis: a syndrome mimicking hereditary hemorrhagic telangiectasia". Bulletin of the Johns Hopkins Hospital 114: 31–83.

CREST syndrome | definition of CREST syndrome by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
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 The word forming the third letter of the acronym is spelt ‘esophageal’ in the USA. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
Thibierge,
Georges, French physician, 1856-1926. Thibierge-Weissenbach syndrome - calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Synonym (s): CREST syndrome
Medical Eponyms © Farlex 2012
CREST syn·drome
( krest sin'drōm)
Acronym for variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Dental Professions © Farlex 2012
Want to thank TFD for its existence? Tell a friend about us, add a link to this page, or visit the webmaster's page for free fun content . Link to this page: CREST syndrome
Mentioned in ? acroscleroderma
acrosclerosis
Antinuclear antibodies
autoantibody
Autoimmune Disorders
Brown
Brown Syndrome
Brown, Jason W.
circumscribed scleroderma
crest
crista
CRST syndrome
dermatosclerosis
diffuse scleroderma
generalized scleroderma
intimal sclerosis
linear scleroderma
Localized scleroderma
MS
References in periodicals archive ?

The word forming the third letter of the acronym is spelt ‘esophageal’ in the USA. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
Thibierge,
Georges, French physician, 1856-1926. Thibierge-Weissenbach syndrome - calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Synonym (s): CREST syndrome
Medical Eponyms © Farlex 2012
CREST syn·drome
( krest sin'drōm)
Acronym for variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Dental Professions © Farlex 2012
Want to thank TFD for its existence? Tell a friend about us, add a link to this page, or visit the webmaster's page for free fun content . Link to this page: CREST syndrome
Mentioned in ? acroscleroderma
acrosclerosis
Antinuclear antibodies
autoantibody
Autoimmune Disorders
Brown
Brown Syndrome
Brown, Jason W.
circumscribed scleroderma
crest
crista
CRST syndrome
dermatosclerosis
diffuse scleroderma
generalized scleroderma
intimal sclerosis
linear scleroderma
Localized scleroderma
MS
References in periodicals archive ?

What Are the Symptoms of CREST Syndrome? What Are the Symptoms of CREST Syndrome?
What Are the Symptoms of CREST Syndrome?
What Is CREST Syndrome?
What Are Signs and Symptoms of CREST Syndrome?
What Causes CREST Syndrome?
How Do Doctors Diagnose CREST Syndrome?
What Is the Treatment for CREST Syndrome?
QUESTION
What Are Complications of CREST Syndrome?
What Is the Life Expectancy for CREST Syndrome?
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Telangiectasias are a sign of CREST syndrome. CREST (an acronym for calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome, also called limited scleroderma, is a connective tissue disease that can involve many parts of the body, usually the skin of the forearms, lower legs, face, and neck, as well as the digestive tract, heart, lungs, and kidneys. What Are Signs and Symptoms of CREST Syndrome? Signs and symptoms of CREST syndrome (limited scleroderma) include the following: Calcinosis, or calcium deposits in the connective tissues
Calcium deposits can be tender and painful. Deposits may become ulcerated, have a white chalky substance drain from them, and secondary infection can occur. There may be inflammation at the site of the calcinosis. In rare cases, calcifications may occur near the spine, causing local pain, nerve pain (radiculopathy), and diffuse weakness.

Guide
What Are the Symptoms of CREST Syndrome? Topic Guide
What Is CREST Syndrome? Share Your Story
Telangiectasias are a sign of CREST syndrome. CREST (an acronym for calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome, also called limited scleroderma, is a connective tissue disease that can involve many parts of the body, usually the skin of the forearms, lower legs, face, and neck, as well as the digestive tract, heart, lungs, and kidneys. What Are Signs and Symptoms of CREST Syndrome? Signs and symptoms of CREST syndrome (limited scleroderma) include the following: Calcinosis, or calcium deposits in the connective tissues
Calcium deposits can be tender and painful. Deposits may become ulcerated, have a white chalky substance drain from them, and secondary infection can occur. There may be inflammation at the site of the calcinosis. In rare cases, calcifications may occur near the spine, causing local pain, nerve pain (radiculopathy), and diffuse weakness.

Raising Awareness for CREST Syndrome | The Mighty Why More Doctors Need to Understand CREST Syndrome
Why More Doctors Need to Understand CREST Syndrome
But it’s important to put it out there – CREST syndrome exists. We exist.
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 Raising Awareness for CREST Syndrome | The Mighty
CREST Disease
Why More Doctors Need to Understand CREST Syndrome
Samantha Gill
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June 26, 2018
June is CREST Syndrome Awareness Month — a rare condition referring to its main features: calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. You can’t “catch it” because it’s not contagious. There is no vaccine to prevent it. It is a systemic autoimmune disease, also known as “limited scleroderma,” since it is a subtype of scleroderma. There is no cure, and it is often progressive, sometimes fatal. It affects every age and gender. Life expectancy is also lower for those with CREST syndrome. “ Women in a group studied in 2017 had a life expectancy 22.4 years shorter than the general population. For men, in the same group in 2017, it was 26 years shorter.

Raising Awareness for CREST Syndrome | The Mighty

Why More Doctors Need to Understand CREST Syndrome
Why More Doctors Need to Understand CREST Syndrome
But it’s important to put it out there – CREST syndrome exists. We exist.
The Mighty Asks
Continue Reading
Advertisement

Raising Awareness for CREST Syndrome | The Mighty
CREST Disease
Why More Doctors Need to Understand CREST Syndrome
Samantha Gill
•
Follow
June 26, 2018
June is CREST Syndrome Awareness Month — a rare condition referring to its main features: calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. You can’t “catch it” because it’s not contagious. There is no vaccine to prevent it. It is a systemic autoimmune disease, also known as “limited scleroderma,” since it is a subtype of scleroderma. There is no cure, and it is often progressive, sometimes fatal. It affects every age and gender. Life expectancy is also lower for those with CREST syndrome. “ Women in a group studied in 2017 had a life expectancy 22.4 years shorter than the general population. For men, in the same group in 2017, it was 26 years shorter.

What Are the Symptoms of CREST Syndrome? What Are the Symptoms of CREST Syndrome?
What Are the Symptoms of CREST Syndrome?
What Is CREST Syndrome?
What Are Signs and Symptoms of CREST Syndrome?
What Causes CREST Syndrome?
How Do Doctors Diagnose CREST Syndrome?
What Is the Treatment for CREST Syndrome?
QUESTION
What Are Complications of CREST Syndrome?
What Is the Life Expectancy for CREST Syndrome?
Manage Diabetes in 10 Minutes
Erectile Dysfunction
Type 2 Diabetes Warning Signs
Health Benefits of Sex
Scalp, Hair and Nails
ADHD Symptoms in Children?
Bad Bugs and Their Bites
Sex Drive Killers
Cancerous Tumors
Multiple Sclerosis
Adult Skin Problems
Habits That Wreck Your Teeth
Manage Diabetes in 10 Minutes
Erectile Dysfunction
Type 2 Diabetes Warning Signs
Health Benefits of Sex
Scalp, Hair and Nails
ADHD Symptoms in Children?
Bad Bugs and Their Bites
Sex Drive Killers
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Adult Skin Problems
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 Causes
What Causes CREST Syndrome? Diagnosis
How Do Doctors Diagnose CREST Syndrome? Treatment
What Is the Treatment for CREST Syndrome? Complications
What Are Complications of CREST Syndrome? Life Expectancy
What Is the Life Expectancy for CREST Syndrome? Guide
What Are the Symptoms of CREST Syndrome? Topic Guide
What Is CREST Syndrome? Share Your Story
Telangiectasias are a sign of CREST syndrome. CREST (an acronym for calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome, also called limited scleroderma, is a connective tissue disease that can involve many parts of the body, usually the skin of the forearms, lower legs, face, and neck, as well as the digestive tract, heart, lungs, and kidneys. What Are Signs and Symptoms of CREST Syndrome?

Causes
What Causes CREST Syndrome? Diagnosis
How Do Doctors Diagnose CREST Syndrome? Treatment
What Is the Treatment for CREST Syndrome? Complications
What Are Complications of CREST Syndrome? Life Expectancy
What Is the Life Expectancy for CREST Syndrome? Guide
What Are the Symptoms of CREST Syndrome? Topic Guide
What Is CREST Syndrome? Share Your Story
Telangiectasias are a sign of CREST syndrome. CREST (an acronym for calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome, also called limited scleroderma, is a connective tissue disease that can involve many parts of the body, usually the skin of the forearms, lower legs, face, and neck, as well as the digestive tract, heart, lungs, and kidneys. What Are Signs and Symptoms of CREST Syndrome?

CREST Syndrome | Sunridge Medical Center Symptoms of CREST Syndrome
CREST Syndrome
Symptoms of CREST Syndrome
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 CREST Syndrome | Sunridge Medical Center
CREST Syndrome
CREST syndrome is a slow form of scleroderma, an autoimmune disease causing abnormalities in the blood vessels, degenerative changes, and the scarring of internal organs and joints. Women are four times more likely to develop CREST syndrome. Though this disease is slow moving and the prognosis for CREST syndrome is better than that of Scleroderma, it is still very damaging over time—causing the skin to darken and tighten. This can result in an over-all stiffness or difficulty forming facial expressions. It can cause problems with swallowing or digestion owing to the scar tissue that can form in the esophagus. Symptoms of CREST Syndrome
Some symptoms of CREST syndrome are aches and pains in joints, heartburn, trouble swallowing that can lead to weight loss, and shortness of breath sometimes develops after scar tissue has built up in the esophagus. Other symptoms may include the swelling and thickening of the fingers or tingling and paling of fingers. There is sometimes scarring present around the joints that can cause fingers, wrists, and other joints to stay in a flexed position. Sometimes sufferers experience a grating sound made by joints that are inflamed. Typically, as fingers warm they become bluish in color.

CREST Syndrome | Sunridge Medical Center

Symptoms of CREST Syndrome
CREST Syndrome
Symptoms of CREST Syndrome
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CREST Syndrome | Sunridge Medical Center
CREST Syndrome
CREST syndrome is a slow form of scleroderma, an autoimmune disease causing abnormalities in the blood vessels, degenerative changes, and the scarring of internal organs and joints. Women are four times more likely to develop CREST syndrome. Though this disease is slow moving and the prognosis for CREST syndrome is better than that of Scleroderma, it is still very damaging over time—causing the skin to darken and tighten. This can result in an over-all stiffness or difficulty forming facial expressions. It can cause problems with swallowing or digestion owing to the scar tissue that can form in the esophagus. Symptoms of CREST Syndrome
Some symptoms of CREST syndrome are aches and pains in joints, heartburn, trouble swallowing that can lead to weight loss, and shortness of breath sometimes develops after scar tissue has built up in the esophagus. Other symptoms may include the swelling and thickening of the fingers or tingling and paling of fingers. There is sometimes scarring present around the joints that can cause fingers, wrists, and other joints to stay in a flexed position. Sometimes sufferers experience a grating sound made by joints that are inflamed. Typically, as fingers warm they become bluish in color.

CREST syndrome | definition of CREST syndrome by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
Mentioned in ?
References in periodicals archive ?
Medical browser ?
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 CREST has a slightly better prognosis than other connective tissue disorders, but has late complications—e.g., biliary cirrhosis and pulmonary hypertension
Lab Anticentromere antibodies are characteristic of CREST, but may also be seen in progressive systemic sclerosis, older women, or those with HLA-DR1
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved. CREST syn·drome
( krest sin'drōm)
An acronymic designation for a variant of scleroderma characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Health Professions and Nursing © Farlex 2012
CREST syndrome
Acronym for a connective tissue disorder, related to progressive systemic sclerosis, but limited to CALCINOSIS, RAYNAUD'S PHENOMENON, oesophageal involvement, hardness of the fingers (Sclerodactyly) and dilated skin blood vessels ( TELANGIECTASIA ). The word forming the third letter of the acronym is spelt ‘esophageal’ in the USA. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
Thibierge,
Georges, French physician, 1856-1926. Thibierge-Weissenbach syndrome - calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Synonym (s): CREST syndrome
Medical Eponyms © Farlex 2012
CREST syn·drome
( krest sin'drōm)
Acronym for variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia.

CREST has a slightly better prognosis than other connective tissue disorders, but has late complications—e.g., biliary cirrhosis and pulmonary hypertension
Lab Anticentromere antibodies are characteristic of CREST, but may also be seen in progressive systemic sclerosis, older women, or those with HLA-DR1
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved. CREST syn·drome
( krest sin'drōm)
An acronymic designation for a variant of scleroderma characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Health Professions and Nursing © Farlex 2012
CREST syndrome
Acronym for a connective tissue disorder, related to progressive systemic sclerosis, but limited to CALCINOSIS, RAYNAUD'S PHENOMENON, oesophageal involvement, hardness of the fingers (Sclerodactyly) and dilated skin blood vessels ( TELANGIECTASIA ). The word forming the third letter of the acronym is spelt ‘esophageal’ in the USA. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
Thibierge,
Georges, French physician, 1856-1926. Thibierge-Weissenbach syndrome - calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Synonym (s): CREST syndrome
Medical Eponyms © Farlex 2012
CREST syn·drome
( krest sin'drōm)
Acronym for variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia.

CREST Disease | definition of CREST Disease by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
Mentioned in ?
Medical browser ?
Full browser ?
 Farlex Partner Medical Dictionary © Farlex 2012
An acronym for the pentad of clinical signs seen with a limited form of scleroderma: Calcinosis cutis
Raynaud’s phenomenon—at least a 2-phase colour change
Esophageal distal hypomotility or reflux esophagitis
Sclerodactyly or nonpitting digital edema
Telangiectasia; CREST has a slightly better prognosis than other connective tissue disorders, but has late complications—e.g., biliary cirrhosis and pulmonary hypertension
Lab Anticentromere antibodies are characteristic of CREST, but may also be seen in progressive systemic sclerosis, older women, or those with HLA-DR1
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved. CREST syn·drome
( krest sin'drōm)
An acronymic designation for a variant of scleroderma characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Health Professions and Nursing © Farlex 2012
CREST syndrome
Acronym for a connective tissue disorder, related to progressive systemic sclerosis, but limited to CALCINOSIS, RAYNAUD'S PHENOMENON, oesophageal involvement, hardness of the fingers (Sclerodactyly) and dilated skin blood vessels ( TELANGIECTASIA ). The word forming the third letter of the acronym is spelt ‘esophageal’ in the USA. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
Thibierge,
Georges, French physician, 1856-1926. Thibierge-Weissenbach syndrome - calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia.

Farlex Partner Medical Dictionary © Farlex 2012
An acronym for the pentad of clinical signs seen with a limited form of scleroderma: Calcinosis cutis
Raynaud’s phenomenon—at least a 2-phase colour change
Esophageal distal hypomotility or reflux esophagitis
Sclerodactyly or nonpitting digital edema
Telangiectasia; CREST has a slightly better prognosis than other connective tissue disorders, but has late complications—e.g., biliary cirrhosis and pulmonary hypertension
Lab Anticentromere antibodies are characteristic of CREST, but may also be seen in progressive systemic sclerosis, older women, or those with HLA-DR1
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved. CREST syn·drome
( krest sin'drōm)
An acronymic designation for a variant of scleroderma characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Health Professions and Nursing © Farlex 2012
CREST syndrome
Acronym for a connective tissue disorder, related to progressive systemic sclerosis, but limited to CALCINOSIS, RAYNAUD'S PHENOMENON, oesophageal involvement, hardness of the fingers (Sclerodactyly) and dilated skin blood vessels ( TELANGIECTASIA ). The word forming the third letter of the acronym is spelt ‘esophageal’ in the USA. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
Thibierge,
Georges, French physician, 1856-1926. Thibierge-Weissenbach syndrome - calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia.

CREST Disease | definition of CREST Disease by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
Mentioned in ?
Medical browser ?
Full browser ?
 Synonym (s): CREST syndrome
Medical Eponyms © Farlex 2012
CREST syn·drome
( krest sin'drōm)
Acronym for variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Dental Professions © Farlex 2012
Want to thank TFD for its existence? Tell a friend about us, add a link to this page, or visit the webmaster's page for free fun content . Link to this page: CREST syndrome
Mentioned in ? acroscleroderma
acrosclerosis
Antinuclear antibodies
autoantibody
Autoimmune Disorders
Brown
Brown Syndrome
Brown, Jason W.
circumscribed scleroderma
crest
crista
CRST syndrome
dermatosclerosis
diffuse scleroderma
generalized scleroderma
intimal sclerosis
linear scleroderma
Localized scleroderma
MS
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CREST Syndrome - What is?, Pictures, Symptoms, Treatment, Diagnosis CREST Syndrome
CREST Syndrome
Definition
Symptoms
Tight hardened skin
Raynaud’s phenomenon
Red spot marks on the skin
Lumps beneath the skin
Difficulty in swallowing
Classification
Causes of CREST Syndrome
Risk factors
Complications
Diagnosis
Blood test
Biopsy of the skin sample
Heart, lung and gastrointestinal tests
CREST Syndrome Treatment
Antibiotics
Antacids
Antihypertensive drugs
Immunosuppressive medications
Rehabilitation Therapy
References
 Raynaud’s phenomenon
The blood vessels present in the affected fingers and toes get spasm due to cold weather or mental stress. This can also lead to blocking of the blood circulation and skin become white and then turns to blue, the temperature of the skin becomes lower down and numbness raises. Further improvement of the blood flow can cause throbbing or tingling sensation along with reddish skin. Red spot marks on the skin
The swelling of the small blood vessels beneath the skin surface can cause painless red spot marks on the affected skin surface. Lumps beneath the skin
In rare cases, calcium deposition beneath the skin appears as a lump (telangiectasias) and mainly found in the fingers, elbows or knee. These lumps may be infected and tenderness also develop. Difficulty in swallowing
In CREST syndrome, people often face swallowing difficulties, due to their problem in the esophagus. The loss of control over the esophageal muscles at the upper and lower end can cause difficulty in swallowing and let back flow the acidic content of the stomach into the esophagus. This leads to heartburn, irritation and scarring of the esophagus. ( 1,2,3,4)
Classification
In medical science, depending upon the sign and symptoms, CREST syndrome is further divided into two forms:

Raynaud’s phenomenon
The blood vessels present in the affected fingers and toes get spasm due to cold weather or mental stress. This can also lead to blocking of the blood circulation and skin become white and then turns to blue, the temperature of the skin becomes lower down and numbness raises. Further improvement of the blood flow can cause throbbing or tingling sensation along with reddish skin. Red spot marks on the skin
The swelling of the small blood vessels beneath the skin surface can cause painless red spot marks on the affected skin surface. Lumps beneath the skin
In rare cases, calcium deposition beneath the skin appears as a lump (telangiectasias) and mainly found in the fingers, elbows or knee. These lumps may be infected and tenderness also develop. Difficulty in swallowing
In CREST syndrome, people often face swallowing difficulties, due to their problem in the esophagus. The loss of control over the esophageal muscles at the upper and lower end can cause difficulty in swallowing and let back flow the acidic content of the stomach into the esophagus. This leads to heartburn, irritation and scarring of the esophagus. ( 1,2,3,4)
Classification
In medical science, depending upon the sign and symptoms, CREST syndrome is further divided into two forms:

CREST Syndrome | Sunridge Medical Center Symptoms of CREST Syndrome
CREST Syndrome
Symptoms of CREST Syndrome
Contact Us
Address
Phone
Email
Have A Question Or Just Need More Information?
Don’t hesitate to contact us at anytime. we are here to help
Call Toll Free
1-800-923-7878
 Symptoms of CREST Syndrome
Some symptoms of CREST syndrome are aches and pains in joints, heartburn, trouble swallowing that can lead to weight loss, and shortness of breath sometimes develops after scar tissue has built up in the esophagus. Other symptoms may include the swelling and thickening of the fingers or tingling and paling of fingers. There is sometimes scarring present around the joints that can cause fingers, wrists, and other joints to stay in a flexed position. Sometimes sufferers experience a grating sound made by joints that are inflamed. Typically, as fingers warm they become bluish in color. CREST syndrome can cause heart anomalies such as abnormal rhythms and heart failure. For answers to your questions or to make an appointment, call us toll-free at 866-740-3638 to speak with a Patient Care Representative. Contact Us
Still Have Questions? That’s okay, we know that navigating a new course for your health is never easy, especially with all the information there is out there to have to sort through and process. That is why our Patient Care Representatives strive to provide you with as much knowledge as they possible can so that you can make the best and most informed decisions for you and your loved ones.

Symptoms of CREST Syndrome
Some symptoms of CREST syndrome are aches and pains in joints, heartburn, trouble swallowing that can lead to weight loss, and shortness of breath sometimes develops after scar tissue has built up in the esophagus. Other symptoms may include the swelling and thickening of the fingers or tingling and paling of fingers. There is sometimes scarring present around the joints that can cause fingers, wrists, and other joints to stay in a flexed position. Sometimes sufferers experience a grating sound made by joints that are inflamed. Typically, as fingers warm they become bluish in color. CREST syndrome can cause heart anomalies such as abnormal rhythms and heart failure. For answers to your questions or to make an appointment, call us toll-free at 866-740-3638 to speak with a Patient Care Representative. Contact Us
Still Have Questions? That’s okay, we know that navigating a new course for your health is never easy, especially with all the information there is out there to have to sort through and process. That is why our Patient Care Representatives strive to provide you with as much knowledge as they possible can so that you can make the best and most informed decisions for you and your loved ones.

CREST Disease | definition of CREST Disease by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
Mentioned in ?
Medical browser ?
Full browser ?
 CREST syn·drome
( krest sin'drōm)
An acronymic designation for a variant of scleroderma characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Health Professions and Nursing © Farlex 2012
CREST syndrome
Acronym for a connective tissue disorder, related to progressive systemic sclerosis, but limited to CALCINOSIS, RAYNAUD'S PHENOMENON, oesophageal involvement, hardness of the fingers (Sclerodactyly) and dilated skin blood vessels ( TELANGIECTASIA ). The word forming the third letter of the acronym is spelt ‘esophageal’ in the USA. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
Thibierge,
Georges, French physician, 1856-1926. Thibierge-Weissenbach syndrome - calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Synonym (s): CREST syndrome
Medical Eponyms © Farlex 2012
CREST syn·drome
( krest sin'drōm)
Acronym for variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Dental Professions © Farlex 2012
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CREST syn·drome
( krest sin'drōm)
An acronymic designation for a variant of scleroderma characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Health Professions and Nursing © Farlex 2012
CREST syndrome
Acronym for a connective tissue disorder, related to progressive systemic sclerosis, but limited to CALCINOSIS, RAYNAUD'S PHENOMENON, oesophageal involvement, hardness of the fingers (Sclerodactyly) and dilated skin blood vessels ( TELANGIECTASIA ). The word forming the third letter of the acronym is spelt ‘esophageal’ in the USA. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
Thibierge,
Georges, French physician, 1856-1926. Thibierge-Weissenbach syndrome - calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Synonym (s): CREST syndrome
Medical Eponyms © Farlex 2012
CREST syn·drome
( krest sin'drōm)
Acronym for variant of systemic sclerosis characterized by calcinosis, Raynaud phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia. Medical Dictionary for the Dental Professions © Farlex 2012
Want to thank TFD for its existence? Tell a friend about us, add a link to this page, or visit the webmaster's page for free fun content . Link to this page:

Types of Scleroderma | Johns Hopkins Medicine Types of Scleroderma
Types of Scleroderma
Three Types of Localized Scleroderma: Localized, Generalized and Linear
Circumscribed Morphea
Generalized Morphea
Linear Scleroderma
Three Types of Systemic Sclerosis (Scleroderma): Limited, Diffuse and Sine
Limited Scleroderma
Diffuse Scleroderma
Sine Sclerosis
More Information About Scleroderma in the Health Library
 Some have problems with their GI tract, especially heartburn; severe Raynaud’s and musculoskeletal pain; and a small subset can develop pulmonary hypertension that can be life-threatening. A subtype of limited scleroderma is also known as CREST syndrome. CREST is an acronym for its most prominent clinical features: Calcinosis: calcium deposits under the skin and sometimes in tissues. Raynaud’s phenomenon: an exaggerated response to ambient temperatures making the skin of the fingers or toes cold, numb or tingling with color changes. Esophageal dysmotility:

Types of Scleroderma | Johns Hopkins Medicine

Types of Scleroderma
Types of Scleroderma
Three Types of Localized Scleroderma: Localized, Generalized and Linear
Circumscribed Morphea
Generalized Morphea
Linear Scleroderma
Three Types of Systemic Sclerosis (Scleroderma): Limited, Diffuse and Sine
Limited Scleroderma
Diffuse Scleroderma
Sine Sclerosis
More Information About Scleroderma in the Health Library

Some have problems with their GI tract, especially heartburn; severe Raynaud’s and musculoskeletal pain; and a small subset can develop pulmonary hypertension that can be life-threatening. A subtype of limited scleroderma is also known as CREST syndrome. CREST is an acronym for its most prominent clinical features: Calcinosis: calcium deposits under the skin and sometimes in tissues. Raynaud’s phenomenon: an exaggerated response to ambient temperatures making the skin of the fingers or toes cold, numb or tingling with color changes. Esophageal dysmotility:

CREST syndrome | definition of CREST syndrome by Medical dictionary CREST syndrome
CREST syndrome
CREST syndrome
CREST syn·drome
CREST syn·drome
CREST syndrome
Thibierge,
CREST syn·drome
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 4 (3):132-135. From autoimmune thyroid disease and CREST syndrome to incidental discovery of incipient gastric carcinoma: a case report
To improve sensitivity for milder forms of disease, the condition is often divided into diffuse systemic scleroderma (dSSc) or limited systemic scleroderma (lSSc) (TABLE 1), with CREST syndrome being a variant of the limited form. If CREST syndrome is suspected, it is important to look for its cardinal features. Our patient had all the cardinal features of CREST syndrome on history and physical exam. Elbow nodules: the nodules on the patient's elbow prompted her visit. The fact that she also had frequent heartburn provided an important diagnostic clue
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Dysphagia Mnemonic - BEST USMLE Step 2 CS Mnemonics Dysphagia Mnemonic (difficulty swallowing) – BEST USMLE Step 2 CS Mnemonics
Dysphagia Mnemonic (difficulty swallowing) – BEST USMLE Step 2 CS Mnemonics
Dysphagia Mnemonic (difficulty swallowing):
PHYSICAL EXAMINATION Dysphagia mnemonic
DIFFERENTIAL DIAGNOSIS
DIAGNOSTIC WORKUP
USEFUL LINKS:
 Check throat for erythema and exudate
Neck exam: Check for lymphadenopathy, thyromegaly
Cardiovascular exam: Auscultation
Pulmonary exam: Auscultation
Abdominal exam: Inspection, auscultation, palpation, percussion. Skin: check for signs of scleroderma/CREST. DIFFERENTIAL DIAGNOSIS
Esophageal cancer (Dysphagia starts with Solids and progresses to liquids. Hx of chronic alcoholism, smoking & weight loss )
Achalasia (Dysphasia for BOTH solid and liquids)
Esophagitis (Pain on swallowing. Immunocompromised “e.g. HIV, Corticosteroids”)
Systemic Sclerosis (Look for CREST syndrome)
Gastroesophageal Reflux Disease ‘GERD’ ( Cough at nights, Hoarseness, sore throat)
Plummer-Vinson syndrome (Iron deficiency anemia, sore throat, craving ice, dirt, clay…)
Zenker diverticulum (Halitosis, regurgitation)
Pill-induced esophagitis (e.g. Bisphosphonates)
Mitral Stenosis (look for an immigrant or a pregnant female)
DIAGNOSTIC WORKUP
CBC
Serum iron, ferritin, TIBC
Throat culture
HIV antibody and viral load, CD4 count
Chest X-ray
Barium swallow
Endoscopy
Esophageal manometry
Chest CT
USEFUL LINKS:

Dysphagia Mnemonic - BEST USMLE Step 2 CS Mnemonics

Dysphagia Mnemonic (difficulty swallowing) – BEST USMLE Step 2 CS Mnemonics
Dysphagia Mnemonic (difficulty swallowing) – BEST USMLE Step 2 CS Mnemonics
Dysphagia Mnemonic (difficulty swallowing):
PHYSICAL EXAMINATION Dysphagia mnemonic
DIFFERENTIAL DIAGNOSIS
DIAGNOSTIC WORKUP
USEFUL LINKS:

Check throat for erythema and exudate
Neck exam: Check for lymphadenopathy, thyromegaly
Cardiovascular exam: Auscultation
Pulmonary exam: Auscultation
Abdominal exam: Inspection, auscultation, palpation, percussion. Skin: check for signs of scleroderma/CREST. DIFFERENTIAL DIAGNOSIS
Esophageal cancer (Dysphagia starts with Solids and progresses to liquids. Hx of chronic alcoholism, smoking & weight loss )
Achalasia (Dysphasia for BOTH solid and liquids)
Esophagitis (Pain on swallowing. Immunocompromised “e.g. HIV, Corticosteroids”)
Systemic Sclerosis (Look for CREST syndrome)
Gastroesophageal Reflux Disease ‘GERD’ ( Cough at nights, Hoarseness, sore throat)
Plummer-Vinson syndrome (Iron deficiency anemia, sore throat, craving ice, dirt, clay…)
Zenker diverticulum (Halitosis, regurgitation)
Pill-induced esophagitis (e.g. Bisphosphonates)
Mitral Stenosis (look for an immigrant or a pregnant female)
DIAGNOSTIC WORKUP
CBC
Serum iron, ferritin, TIBC
Throat culture
HIV antibody and viral load, CD4 count
Chest X-ray
Barium swallow
Endoscopy
Esophageal manometry
Chest CT
USEFUL LINKS:

Belching and Heartburn: Common Related Medical Conditions Belching and Heartburn
Belching and Heartburn Esophagitis
Esophagitis, an inflammation of the lining of the esophagus, causes chest pain, nausea, and more. Eating certain foods
Certain foods can cause unusual and sometimes unpleasant side effects, such as bad breath and heartburn. Obesity
Obesity is having too much body fat, marked by a BMI of 30 or higher. Esophageal spasm
Esophageal spasms are sudden, painful contractions in the muscles of the esophagus. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Hyperparathyroidism
Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Advertisement
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©2005-2015 WebMD, LLC.

Belching and Heartburn: Common Related Medical Conditions

Belching and Heartburn
Belching and Heartburn

Esophagitis
Esophagitis, an inflammation of the lining of the esophagus, causes chest pain, nausea, and more. Eating certain foods
Certain foods can cause unusual and sometimes unpleasant side effects, such as bad breath and heartburn. Obesity
Obesity is having too much body fat, marked by a BMI of 30 or higher. Esophageal spasm
Esophageal spasms are sudden, painful contractions in the muscles of the esophagus. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Hyperparathyroidism
Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Advertisement
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©2005-2015 WebMD, LLC.

Ear ache and Heartburn: Common Related Medical Conditions Ear ache and Heartburn
Ear ache and Heartburn Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Hyperparathyroidism
Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Advertisement
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©2005-2015 WebMD, LLC. All rights reserved. WebMD does not provide medical advice, diagnosis or treatment. See additional information.

Ear ache and Heartburn: Common Related Medical Conditions

Ear ache and Heartburn
Ear ache and Heartburn

Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Hyperparathyroidism
Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Advertisement
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©2005-2015 WebMD, LLC. All rights reserved. WebMD does not provide medical advice, diagnosis or treatment. See additional information.

Are the causes of this achalasia known ?
 M. Gosselin, A. Gosselin, A. Ropert, J.F. Bretagne (Rennes)
Difficulty in swallowing can develop at any age owing to a variety of disorders such as cerebral disease, peripheral neuropathies, muscular diseases, local factors and idiopathic upper esophageal sphincter dysfunction. The latter is an extremely rare condition but it is becoming increasingly recognized particularly in the elderly in whom this dysfunction can result in severe defects in eating and nutrition. Upper esophageal sphincter (UES) dysfunction may be a part of a more generalized disorder and the mechanisms responsible for abnormalities of Cricopharyngeal function resulting in oropharyngeal dysphagia (OD) remain controversial. The various diseases listed in the table must be excluded by history, careful inspection of pharynx, hypopharynx and larynx, radiology and endoscopy, before the disorder is diagnosed as being a primary UES dysfunction. The specific defects more likely to cause OD in the aging population are strokes, Parkinson's disease, primary myositis, hyperthyroidism, cervical tumors, surgical resection of the
hypopharynx and cervical spine osteophytes. Neurogenic and myogenic causes account for 80 per cent of instances, whereas local lesions and dysfunction are responsible for the rest. The neurologic system may be involved at any level of the afferent or efferent pathway or in the brain stem and the cortex, where integration of the information of swallowing takes place. Cerebrovascular accidents frequently bring on swallowing problems in the elderly people, particularly when the brain stem is involved as in pseudobulbar palsy. In other neurologic diseases UES dysfunction is also largely due to destruction of the motor nuclei in the brain stem. No single and specific disorder of swallowing is observed in multiple sclerosis and Parkinsonism.

Are the causes of this achalasia known ?

Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness: Common Related Medical Conditions Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness
Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Scleroderma
Scleroderma is an uncommon immune disorder that causes collagen to build up in the tissue, making it harden. Hiatal hernia
When hiatal hernia symptoms do occur, they include chest pain and burning, sweating, a bitter taste and more. Esophageal cancer
Esophageal cancer starts in the lining of the esophagus and can cause difficulty swallowing. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Advertisement
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Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness: Common Related Medical Conditions

Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness
Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness

Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Scleroderma
Scleroderma is an uncommon immune disorder that causes collagen to build up in the tissue, making it harden. Hiatal hernia
When hiatal hernia symptoms do occur, they include chest pain and burning, sweating, a bitter taste and more. Esophageal cancer
Esophageal cancer starts in the lining of the esophagus and can cause difficulty swallowing. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Advertisement
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Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness: Common Related Medical Conditions Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness
Difficulty swallowing, Palpitations (fluttering in chest) and Pressure or heaviness Esophageal spasm
Esophageal spasms are sudden, painful contractions in the muscles of the esophagus. Tracheo-esophageal fistula
A tracheoesophageal is a birth defect that causes bluish skin, poor feeding, choking, coughing and drooling. Esophageal stricture
An esophageal stricture is a spot where the esophagus narrows causing swallowing to be difficult and painful. Bleeding esophageal varices
Esophageal varices are caused by high blood pressure and lead to a bloody cough and black, tarry stools. Aortic aneurysm (chest)
Thoracic aortic aneurysm is the swelling of the chest aorta and can cause chest or back pain. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Scleroderma
Scleroderma is an uncommon immune disorder that causes collagen to build up in the tissue, making it harden. Hiatal hernia
When hiatal hernia symptoms do occur, they include chest pain and burning, sweating, a bitter taste and more. Esophageal cancer
Esophageal cancer starts in the lining of the esophagus and can cause difficulty swallowing. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body.

Esophageal spasm
Esophageal spasms are sudden, painful contractions in the muscles of the esophagus. Tracheo-esophageal fistula
A tracheoesophageal is a birth defect that causes bluish skin, poor feeding, choking, coughing and drooling. Esophageal stricture
An esophageal stricture is a spot where the esophagus narrows causing swallowing to be difficult and painful. Bleeding esophageal varices
Esophageal varices are caused by high blood pressure and lead to a bloody cough and black, tarry stools. Aortic aneurysm (chest)
Thoracic aortic aneurysm is the swelling of the chest aorta and can cause chest or back pain. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Scleroderma
Scleroderma is an uncommon immune disorder that causes collagen to build up in the tissue, making it harden. Hiatal hernia
When hiatal hernia symptoms do occur, they include chest pain and burning, sweating, a bitter taste and more. Esophageal cancer
Esophageal cancer starts in the lining of the esophagus and can cause difficulty swallowing. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body.

Heartburn, Numbness or tingling, Numbness or tingling and Numbness or tingling: Common Related Medical Conditions Heartburn, Numbness or tingling (Upper arm (tricep)), Numbness or tingling (Forearm (extensor)) and Numbness or tingling (Hand (back))
Heartburn, Numbness or tingling (Upper arm (tricep)), Numbness or tingling (Forearm (extensor)) and Numbness or tingling (Hand (back)) Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Advertisement
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©2005-2015 WebMD, LLC. All rights reserved. WebMD does not provide medical advice, diagnosis or treatment. See additional information.

Heartburn, Numbness or tingling, Numbness or tingling and Numbness or tingling: Common Related Medical Conditions

Heartburn, Numbness or tingling (Upper arm (tricep)), Numbness or tingling (Forearm (extensor)) and Numbness or tingling (Hand (back))
Heartburn, Numbness or tingling (Upper arm (tricep)), Numbness or tingling (Forearm (extensor)) and Numbness or tingling (Hand (back))

Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Advertisement
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©2005-2015 WebMD, LLC. All rights reserved. WebMD does not provide medical advice, diagnosis or treatment. See additional information.

Choking on food, Difficulty swallowing, Food getting stuck (swallowing) and Throat tightness: Common Related Medical Conditions Choking on food, Difficulty swallowing, Food getting stuck (swallowing) and Throat tightness
Choking on food, Difficulty swallowing, Food getting stuck (swallowing) and Throat tightness Achalasia
Achalasia is a condition that makes it hard for food and liquid to move from the esophagus into the stomach. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Throat cancer
Throat cancer can cause symptoms including difficulty swallowing, hoarseness, and chronic cough. Advertisement
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©2005-2015 WebMD, LLC. All rights reserved. WebMD does not provide medical advice, diagnosis or treatment. See additional information.

Choking on food, Difficulty swallowing, Food getting stuck (swallowing) and Throat tightness: Common Related Medical Conditions

Choking on food, Difficulty swallowing, Food getting stuck (swallowing) and Throat tightness
Choking on food, Difficulty swallowing, Food getting stuck (swallowing) and Throat tightness

Achalasia
Achalasia is a condition that makes it hard for food and liquid to move from the esophagus into the stomach. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body. Throat cancer
Throat cancer can cause symptoms including difficulty swallowing, hoarseness, and chronic cough. Advertisement
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Pharyngeal Constrictor - an overview | ScienceDirect Topics Pharyngeal Constrictor
Pharyngeal Constrictor
Zenker's Diverticulum
Anatomy
Cricopharyngeal Dysphagia
Introduction
Anatomy and Physiology of the Upper Esophageal Sphincter
Innervation
Circadian Rhythm Sleep Disorders (CRSD)
Pharyngeal Constrictor Muscles
Speech, Mastication, and Swallowing Considerations in the Evaluation and Treatment of Dentofacial Deformities
Swallowing: Second Stage
Zenker's Diverticulum
Abstract
Benign Esophageal Disease
Location
Otolaryngological aspects of orofacial pain
4.6 Retropharyngeal Space Infection
Management of Gut Dysmotility
Multiple Sclerosis
Endoscopic Diagnosis and Management of Zenker's Diverticula
Pathophysiology
 Many neuromuscular diseases such as amyotrophic lateral sclerosis, polymyositis, myasthenia gravis, multiple sclerosis, Parkinson's disease (PD), and cerebrovascular accidents result in reduced CP relaxation. These conditions also lead to reduced pharyngeal contraction and hyolaryngeal elevation from muscular weakness and compound the reduced UES opening. CP achalasia, failure of CP relaxation, may also be idiopathic or result from gastroesophageal reflux disease among other etiologies. Cricopharyngeal dysfunction refers broadly to poor compliance of the UES or pharyngoesophageal segment resulting in reduced or absent opening during swallowing. It may result from primary neuromuscular dysfunction, mechanical obstruction or stenosis of the UES, or from discoordination of the UES opening with the rest of the swallow. Depending on the severity of dysfunction, symptoms may be absent or patients may complain of dysphagia, regurgitation, cough, aspiration, weight loss, dysphonia, and/or globus. 2 Misdirection of the food bolus or penetration of the laryngeal vestibule may lead to cough, choking, and/or aspiration. Globus, which is experienced by many patients with UES dysfunction, has also been uniquely correlated with hyperdynamic respiratory UES pressure fluctuations as well as higher residual UES pressures on average when compared to nondysphagic controls (2.6 mmHg vs. 0.6 mmHg). 3,4
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URL: https://www.sciencedirect.com/science/article/pii/B978032356930900019X
Anatomy and Physiology of the Upper Esophageal Sphincter
Valeria Silva Merea MD, Michael J. Pitman MD, in Dysphagia Evaluation and Management in Otolaryngology, 2019
Innervation
Studies tracing nerves using Sihler's stain have shown that the IPC is supplied by the dense pharyngeal plexus.

Pharyngeal Constrictor - an overview | ScienceDirect Topics

Pharyngeal Constrictor
Pharyngeal Constrictor
Zenker's Diverticulum
Anatomy
Cricopharyngeal Dysphagia
Introduction
Anatomy and Physiology of the Upper Esophageal Sphincter
Innervation
Circadian Rhythm Sleep Disorders (CRSD)
Pharyngeal Constrictor Muscles
Speech, Mastication, and Swallowing Considerations in the Evaluation and Treatment of Dentofacial Deformities
Swallowing: Second Stage
Zenker's Diverticulum
Abstract
Benign Esophageal Disease
Location
Otolaryngological aspects of orofacial pain
4.6 Retropharyngeal Space Infection
Management of Gut Dysmotility
Multiple Sclerosis
Endoscopic Diagnosis and Management of Zenker's Diverticula
Pathophysiology

Heartburn and Upset stomach: Common Related Medical Conditions Heartburn and Upset stomach
Heartburn and Upset stomach Peptic ulcer
Peptic ulcers, sores in the lining of the stomach or upper intestine, cause abdominal pain, gas, and more. Gastroenteritis
Gastroenteritis is inflammation of the stomach and intestine that causes diarrhea and vomiting. Esophagitis
Esophagitis, an inflammation of the lining of the esophagus, causes chest pain, nausea, and more. Esophageal spasm
Esophageal spasms are sudden, painful contractions in the muscles of the esophagus. Hiatal hernia
When hiatal hernia symptoms do occur, they include chest pain and burning, sweating, a bitter taste and more. Obesity
Obesity is having too much body fat, marked by a BMI of 30 or higher. Generalized anxiety disorder
Generalized anxiety disorder is a condition in which a person has nearly constant anxiety. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Hyperparathyroidism
Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body.

Heartburn and Upset stomach: Common Related Medical Conditions

Heartburn and Upset stomach
Heartburn and Upset stomach

Peptic ulcer
Peptic ulcers, sores in the lining of the stomach or upper intestine, cause abdominal pain, gas, and more. Gastroenteritis
Gastroenteritis is inflammation of the stomach and intestine that causes diarrhea and vomiting. Esophagitis
Esophagitis, an inflammation of the lining of the esophagus, causes chest pain, nausea, and more. Esophageal spasm
Esophageal spasms are sudden, painful contractions in the muscles of the esophagus. Hiatal hernia
When hiatal hernia symptoms do occur, they include chest pain and burning, sweating, a bitter taste and more. Obesity
Obesity is having too much body fat, marked by a BMI of 30 or higher. Generalized anxiety disorder
Generalized anxiety disorder is a condition in which a person has nearly constant anxiety. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Hyperparathyroidism
Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body.

 Abstract
Background
Cricopharyngeal dysfunction is a narrowing at the level of the upper oesophageal sphincter caused by failed or incomplete sphincter opening as a result of lack of pharyngoesophageal coordination or reduction in the muscular compliance of the upper oesophageal sphincter. Oropharyngeal dysphagia is a typical symptom. Videomanometry allows direct comparison of pressure readings with dynamic anatomy during swallowing. Methods
This is a prospective randomized pilot study that compares the effect of balloon dilatation and laser myotomy in cricopharyngeal dysfunction. We used videomanometry as an objective measure and the Swedish version of Sydney Swallowing Questionnaire as patient’s self-assessment at baseline and 1 and 6 months after treatment. Results
The UES sagittal diameter increased from 5.6 mm pre-operatively to 8.4 mm 6 months post-operatively with no differences between treatment groups. Preoperative mean Sydney Swallowing Questionnaire score was 770 and 6 months post-operative score 559, with no difference between the treatments in our cohort. Conclusion
Cricopharyngeal dysfunction treatment by either laser myotomy or balloon dilatation improved upper oesophageal sphincter opening during at least 6 months. Trial registration: ISRCTN84905610, date:

Abstract
Background
Cricopharyngeal dysfunction is a narrowing at the level of the upper oesophageal sphincter caused by failed or incomplete sphincter opening as a result of lack of pharyngoesophageal coordination or reduction in the muscular compliance of the upper oesophageal sphincter. Oropharyngeal dysphagia is a typical symptom. Videomanometry allows direct comparison of pressure readings with dynamic anatomy during swallowing. Methods
This is a prospective randomized pilot study that compares the effect of balloon dilatation and laser myotomy in cricopharyngeal dysfunction. We used videomanometry as an objective measure and the Swedish version of Sydney Swallowing Questionnaire as patient’s self-assessment at baseline and 1 and 6 months after treatment. Results
The UES sagittal diameter increased from 5.6 mm pre-operatively to 8.4 mm 6 months post-operatively with no differences between treatment groups. Preoperative mean Sydney Swallowing Questionnaire score was 770 and 6 months post-operative score 559, with no difference between the treatments in our cohort. Conclusion
Cricopharyngeal dysfunction treatment by either laser myotomy or balloon dilatation improved upper oesophageal sphincter opening during at least 6 months. Trial registration: ISRCTN84905610, date:

Esophageal dysphagia - Wikipedia Esophageal dysphagia
Esophageal dysphagia
Contents
Signs and symptoms
Causes
Differential diagnosis
Main article: esophageal web
Main article: achalasia
Rare causes of esophageal dysphagia not mentioned above
Diagnostic tools
Treatment
References
External links
 Other symptoms of achalasia include regurgitation, night coughing, chest pain, weight loss, and heartburn. The combination of achalasia, adrenal insufficiency, and alacrima (lack of tear production) in children is known as the triple-A (Allgrove) syndrome. In most cases the cause is unknown (idiopathic), but in some regions of the world, achalasia can also be caused by Chagas disease due to infection by Trypanosoma cruzi . Main article: achalasia
Scleroderma is a disease characterized by atrophy and sclerosis of the gut wall, most commonly of the distal esophagus (~90%). Consequently, the lower esophageal sphincter cannot close and this can lead to severe gastroesophageal reflux disease (GERD). Patients typically present with progressive dysphagia to both solids and liquids secondary to motility problems or peptic stricture from acid reflux. Main article: scleroderma
Spastic motility disorders include diffuse esophageal spasm (DES), nutcracker esophagus, hypertensive lower esophageal sphincter, and nonspecific spastic esophageal motility disorders (NEMD). DES can be caused by many factors that affect muscular or neural functions, including acid reflux, stress, hot or cold food, or carbonated drinks.

Esophageal dysphagia - Wikipedia

Esophageal dysphagia
Esophageal dysphagia
Contents
Signs and symptoms
Causes
Differential diagnosis
Main article: esophageal web
Main article: achalasia
Rare causes of esophageal dysphagia not mentioned above
Diagnostic tools
Treatment
References
External links

Other symptoms of achalasia include regurgitation, night coughing, chest pain, weight loss, and heartburn. The combination of achalasia, adrenal insufficiency, and alacrima (lack of tear production) in children is known as the triple-A (Allgrove) syndrome. In most cases the cause is unknown (idiopathic), but in some regions of the world, achalasia can also be caused by Chagas disease due to infection by Trypanosoma cruzi . Main article: achalasia
Scleroderma is a disease characterized by atrophy and sclerosis of the gut wall, most commonly of the distal esophagus (~90%). Consequently, the lower esophageal sphincter cannot close and this can lead to severe gastroesophageal reflux disease (GERD). Patients typically present with progressive dysphagia to both solids and liquids secondary to motility problems or peptic stricture from acid reflux. Main article: scleroderma
Spastic motility disorders include diffuse esophageal spasm (DES), nutcracker esophagus, hypertensive lower esophageal sphincter, and nonspecific spastic esophageal motility disorders (NEMD). DES can be caused by many factors that affect muscular or neural functions, including acid reflux, stress, hot or cold food, or carbonated drinks.

Aspiration Syndromes: Background, Pathophysiology, Epidemiology Aspiration Syndromes
Aspiration Syndromes
Background
 Swallowing dysfunction in conjunction with GER is more likely to cause respiratory symptoms than GER symptoms alone. Eosinophilic GI disorders (eg, eosinophilic esophagitis, gastroenteritis) may also manifest similarly to GER but are refractory to traditional reflux therapies. Joint clinical practice guidelines for evaluation and treatment of GER in infants and children have been developed by The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). [ 1]
Swallowing dysfunction is a known etiology of aspiration in children. Divided into 4 distinct phases, swallowing is a complex action that involves 5 cranial nerves and 26 muscles. The mouth, pharynx, larynx, and esophagus are involved in a coordinated effort to induce swallowing. Any anatomic, neurologic, or physiologic defect in the swallowing mechanism during the preparatory, oral, pharyngeal, or esophageal phases may lead to aspiration. Cricopharyngeal dysfunction, cricopharyngeal incoordination of infancy, and transient pharyngeal muscle dysfunction are well described in the pediatric literature. Cricopharyngeal dysfunction involves cricopharyngeal muscle spasm or achalasia of the superior esophageal sphincter. Cricopharyngeal incoordination of infancy is noted in infants who have a normal suck reflex but have incoordination during swallowing;

Aspiration Syndromes: Background, Pathophysiology, Epidemiology

Aspiration Syndromes
Aspiration Syndromes
Background

Swallowing dysfunction in conjunction with GER is more likely to cause respiratory symptoms than GER symptoms alone. Eosinophilic GI disorders (eg, eosinophilic esophagitis, gastroenteritis) may also manifest similarly to GER but are refractory to traditional reflux therapies. Joint clinical practice guidelines for evaluation and treatment of GER in infants and children have been developed by The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). [ 1]
Swallowing dysfunction is a known etiology of aspiration in children. Divided into 4 distinct phases, swallowing is a complex action that involves 5 cranial nerves and 26 muscles. The mouth, pharynx, larynx, and esophagus are involved in a coordinated effort to induce swallowing. Any anatomic, neurologic, or physiologic defect in the swallowing mechanism during the preparatory, oral, pharyngeal, or esophageal phases may lead to aspiration. Cricopharyngeal dysfunction, cricopharyngeal incoordination of infancy, and transient pharyngeal muscle dysfunction are well described in the pediatric literature. Cricopharyngeal dysfunction involves cricopharyngeal muscle spasm or achalasia of the superior esophageal sphincter. Cricopharyngeal incoordination of infancy is noted in infants who have a normal suck reflex but have incoordination during swallowing;

Esophageal Motility Disorder - an overview | ScienceDirect Topics Esophageal Motility Disorder
Esophageal Motility Disorder
Esophageal Motility Disorders
Introduction
Mixed Connective Tissue Disease and Undifferentiated Connective Tissue Disease
Gastrointestinal System
Techniques of High-Resolution Esophageal Manometry, Classification and Treatment of Spastic Esophageal Motility Disorders
Conclusions
Stable Angina Pectoris
Esophageal Motility Disorders
High-Resolution Esophageal Manometry
Conclusion
Alimentary System and the Peritoneum, Omentum, Mesentery, and Peritoneal Cavity1
Achalasia.
Motility Disorders of the Esophagus
Nonspecific Esophageal Motility Disorder
Esophageal body motility disorders
Symptoms
The Upper Gastrointestinal Tract
DIFFUSE ESOPHAGEAL SPASM
Inflammatory Disorders of the Esophagus
ACHALASIA
 For these reasons, it is important that surgeons have a firm understanding of the principles of HRM diagnosis and its application in surgical decision making. View chapter Purchase book
Read full chapter
URL: https://www.sciencedirect.com/science/article/pii/B978032340232300008X
Alimentary System and the Peritoneum, Omentum, Mesentery, and Peritoneal Cavity1
Howard B. Gelberg, in Pathologic Basis of Veterinary Disease (Sixth Edition), 2017
Achalasia. Esophageal motility disorders are termed achalasia. In this condition the sequential contractility of the esophagus is defective, and the lower cricopharyngeal sphincter fails to function properly. Achalasia results in difficulty in swallowing and may be responsible for regurgitation and weight loss. Cricopharyngeal achalasia is a congenital, possibly neurogenic, disorder of the upper esophageal (cricopharyngeal) sphincter. It occurs in young, small-breed dogs, particularly terriers, cocker spaniels, and miniature poodles. Postweaning dysphagia and regurgitation after a meal of solid food is characteristic of this functional disorder. Liquids are generally swallowed without incidence.

Esophageal Motility Disorder - an overview | ScienceDirect Topics

Esophageal Motility Disorder
Esophageal Motility Disorder
Esophageal Motility Disorders
Introduction
Mixed Connective Tissue Disease and Undifferentiated Connective Tissue Disease
Gastrointestinal System
Techniques of High-Resolution Esophageal Manometry, Classification and Treatment of Spastic Esophageal Motility Disorders
Conclusions
Stable Angina Pectoris
Esophageal Motility Disorders
High-Resolution Esophageal Manometry
Conclusion
Alimentary System and the Peritoneum, Omentum, Mesentery, and Peritoneal Cavity1
Achalasia.
Motility Disorders of the Esophagus
Nonspecific Esophageal Motility Disorder
Esophageal body motility disorders
Symptoms
The Upper Gastrointestinal Tract
DIFFUSE ESOPHAGEAL SPASM
Inflammatory Disorders of the Esophagus
ACHALASIA

For these reasons, it is important that surgeons have a firm understanding of the principles of HRM diagnosis and its application in surgical decision making. View chapter Purchase book
Read full chapter
URL: https://www.sciencedirect.com/science/article/pii/B978032340232300008X
Alimentary System and the Peritoneum, Omentum, Mesentery, and Peritoneal Cavity1
Howard B. Gelberg, in Pathologic Basis of Veterinary Disease (Sixth Edition), 2017
Achalasia. Esophageal motility disorders are termed achalasia. In this condition the sequential contractility of the esophagus is defective, and the lower cricopharyngeal sphincter fails to function properly. Achalasia results in difficulty in swallowing and may be responsible for regurgitation and weight loss. Cricopharyngeal achalasia is a congenital, possibly neurogenic, disorder of the upper esophageal (cricopharyngeal) sphincter. It occurs in young, small-breed dogs, particularly terriers, cocker spaniels, and miniature poodles. Postweaning dysphagia and regurgitation after a meal of solid food is characteristic of this functional disorder. Liquids are generally swallowed without incidence.

Cricopharyngeal Dysfunction | Columbia University Medical Center Department of Otolaryngology Head and Neck Surgery Cricopharyngeal Dysfunction
Cricopharyngeal Dysfunction
Cricopharyngeal Dysfunction
What is cricopharyngeal dysfunction?
How is cricopharyngeal dysfunction diagnosed?
How is cricopharyngeal dysfunction treated?
What is the outlook for people with cricopharyngeal dysfunction?
Make an Appointment
 Cricopharyngeal Dysfunction | Columbia University Medical Center Department of Otolaryngology Head and Neck Surgery

Cricopharyngeal Dysfunction
Cricopharyngeal Dysfunction
What is cricopharyngeal dysfunction? The esophagus, the muscular tube that connects the throat and the stomach, has a muscular sphincter at its upper end that controls the passage of food into the stomach. This upper esophageal sphincter (UES)—also called the cricopharyngeus—is a semi-circular muscle located in the neck about three inches below the Adam’s apple. To prevent the reflux of foods from the esophagus into the throat, the cricopharyngeus remains contracted and tight at most times. When a person swallows, though, it relaxes and allows food to pass through. In people with cricopharyngeal dysfunction, the muscle doesn’t relax, and the food is blocked from passing into the esophagus. They generally have a harder time swallowing solid foods than liquids because liquids flow more easily through the limited opening in the sphincter. The problem tends to progress gradually and slowly over time, and people with cricopharyngeal dysfunction may limit their diet to only very soft foods such as pasta or pureed foods. In severe cases, those with this disorder change their diet so drastically that they lose a lot of weight. Cricopharyngeal dysfunction is also called upper esophageal sphincter dysfunction or cricopharyngeal achalasia.

Cricopharyngeal Dysfunction | Columbia University Medical Center Department of Otolaryngology Head and Neck Surgery

Cricopharyngeal Dysfunction
Cricopharyngeal Dysfunction
Cricopharyngeal Dysfunction
What is cricopharyngeal dysfunction?
How is cricopharyngeal dysfunction diagnosed?
How is cricopharyngeal dysfunction treated?
What is the outlook for people with cricopharyngeal dysfunction?
Make an Appointment

Cricopharyngeal Dysfunction | Columbia University Medical Center Department of Otolaryngology Head and Neck Surgery

Cricopharyngeal Dysfunction
Cricopharyngeal Dysfunction
What is cricopharyngeal dysfunction? The esophagus, the muscular tube that connects the throat and the stomach, has a muscular sphincter at its upper end that controls the passage of food into the stomach. This upper esophageal sphincter (UES)—also called the cricopharyngeus—is a semi-circular muscle located in the neck about three inches below the Adam’s apple. To prevent the reflux of foods from the esophagus into the throat, the cricopharyngeus remains contracted and tight at most times. When a person swallows, though, it relaxes and allows food to pass through. In people with cricopharyngeal dysfunction, the muscle doesn’t relax, and the food is blocked from passing into the esophagus. They generally have a harder time swallowing solid foods than liquids because liquids flow more easily through the limited opening in the sphincter. The problem tends to progress gradually and slowly over time, and people with cricopharyngeal dysfunction may limit their diet to only very soft foods such as pasta or pureed foods. In severe cases, those with this disorder change their diet so drastically that they lose a lot of weight. Cricopharyngeal dysfunction is also called upper esophageal sphincter dysfunction or cricopharyngeal achalasia.

Are the causes of this achalasia known ?
 In the latter, lingual hesitancy and piece-meal deglutition may induce difficulties in bolus formation but the incomplete UES relaxation observed in several studies is not found by Logemann in a series of more than 100 patients [ 8 ]. In chronic schizophrenia, there is a striking incidence of cinefluorographic abnormalities of swallowing [ 2] regardless of the neuroleptic agents that occasionally have been discussed as a possible cause of laryngopharyngeal dystonia [ 9 ]. Peripheral nerve involvement usually due to a lesion in the upper portion of the vagus nerve trunk may result from neck surgery, neoplasm, injury by lead or bacterial toxins (botulism, rabies, tetanus) or mononeuritis multiplex. Some of the esophageal muscular dysfunction observed in diabetics is independent of neuropathy yet is strongly associated with psychiatric disorder. Diseases that directly affect muscular activity also may result in swallowing difficulties in the elderly. Most common among these diseases are myotonic and oculopharyngeal dystrophies, myasthenia gravis, myositis and myopathy of the thyrotoxicosis. When neurologic or muscular disease and also iatrogenic (neck operations, radiation therapy) or mechanical causes have been excluded OD can be attributed to an idiopathic dysfunction limited to the UES. Ever since its introduction in 1950 by Asherson [ 1 ], the term cricopharyngeal achalasia (CPA) has been widely accepted and indiscriminately applied to patients with a wide variety of abnormalities of UES function such as altered resting tone (hypertensive UES), abnormal relaxation (absent, incomplete or delayed relaxation) or premature closure of UES. Strictly speaking, the term CPA denotes absence of relaxation or incomplete relaxation in response to swallowing; it must be reserved for this type of UES motor disorder and the diagnosis confirmed with a high fidelity manometric device such as a low compliance system and spatially oriented manometry.

Dysphagia and Regurgitation in Dogs--More Common Than You Think! - UCDCMC2008 - VIN
Anatomical Localization of Dysphagia
Diagnosis of Swallowing Disorders
Specific Diseases of the Oropharynx and Esophagus
1. Cricopharyngeal Dysphagia
2. Megaesophagus
3. Esophageal Obstruction
4. Esophagitis
5. Esophageal Neoplasia
Specific Diseases of the Gastroesophageal Region
References
 The cricopharyngeal stage involves the relaxation of the cricopharyngeal muscles (upper esophageal sphincter) and passage of the bolus into the proximal esophagus. Normal passage of the bolus into the esophagus is dependent on synchrony between the constriction of the pharyngeal muscles and relaxation of the cricopharyngeus muscle. Failure of the bolus to pass through the cricopharyngeus region is called cricopharyngeal dysphagia. Table 1 contains a list of differential diagnoses for disorders affecting each of the anatomical regions affecting the swallowing reflex. Table 1. Anatomic localization
Differential diagnoses
Oropharyngeal dysphagias

Oral phase
Cranial nerve V, VII and XIII dysfunction, skull fractures, oral masses or foreign bodies
Pharyngeal phase
Pharyngeal abscess, foreign body or mass, Cranial nerve V, VII, X, and IX dysfunction resulting in pharyngeal paresis/paralysis
Cricopharyngeal phase
Cricopharyngeal achalasia, cricopharyngeal dyssynchrony
Esophageal dysphagias
Primary (idiopathic) megaesophagus, secondary megaesophagus, esophageal stricture, mass, granuloma, foreign body, extra-esophageal compression, esophageal diverticulum
Gastroesophageal dysphagias
Hiatal hernia, periesophageal hernia, gastroesophageal intussusceptions, reflux esophagitis
Diagnosis of Swallowing Disorders
1. History: The age of onset of the dysphagia and the breed should be determined. Congenital problems are usually due to idiopathic megaesophagus or vascular ring anomalies, but occasionally foreign bodies or cricopharyngeal dysphagia will be diagnosed. If the patient shows signs of dysphagia in adulthood, the likelihood of a recent anesthesia or exposure to caustic chemicals, foreign bodies, or toxic agents should be evaluated.

Dysphagia and Regurgitation in Dogs--More Common Than You Think! - UCDCMC2008 - VIN

Anatomical Localization of Dysphagia
Diagnosis of Swallowing Disorders
Specific Diseases of the Oropharynx and Esophagus
1. Cricopharyngeal Dysphagia
2. Megaesophagus
3. Esophageal Obstruction
4. Esophagitis
5. Esophageal Neoplasia
Specific Diseases of the Gastroesophageal Region
References

The cricopharyngeal stage involves the relaxation of the cricopharyngeal muscles (upper esophageal sphincter) and passage of the bolus into the proximal esophagus. Normal passage of the bolus into the esophagus is dependent on synchrony between the constriction of the pharyngeal muscles and relaxation of the cricopharyngeus muscle. Failure of the bolus to pass through the cricopharyngeus region is called cricopharyngeal dysphagia. Table 1 contains a list of differential diagnoses for disorders affecting each of the anatomical regions affecting the swallowing reflex. Table 1. Anatomic localization
Differential diagnoses
Oropharyngeal dysphagias

Oral phase
Cranial nerve V, VII and XIII dysfunction, skull fractures, oral masses or foreign bodies
Pharyngeal phase
Pharyngeal abscess, foreign body or mass, Cranial nerve V, VII, X, and IX dysfunction resulting in pharyngeal paresis/paralysis
Cricopharyngeal phase
Cricopharyngeal achalasia, cricopharyngeal dyssynchrony
Esophageal dysphagias
Primary (idiopathic) megaesophagus, secondary megaesophagus, esophageal stricture, mass, granuloma, foreign body, extra-esophageal compression, esophageal diverticulum
Gastroesophageal dysphagias
Hiatal hernia, periesophageal hernia, gastroesophageal intussusceptions, reflux esophagitis
Diagnosis of Swallowing Disorders
1. History: The age of onset of the dysphagia and the breed should be determined. Congenital problems are usually due to idiopathic megaesophagus or vascular ring anomalies, but occasionally foreign bodies or cricopharyngeal dysphagia will be diagnosed. If the patient shows signs of dysphagia in adulthood, the likelihood of a recent anesthesia or exposure to caustic chemicals, foreign bodies, or toxic agents should be evaluated.

Cricopharyngeus Muscle - an overview | ScienceDirect Topics Cricopharyngeus Muscle
Cricopharyngeus Muscle
The Patient with a Full Stomach
2 Upper Esophageal Sphincter Tone
Cricopharyngeal Achalasia
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
Esophagus
Cricopharyngeal Achalasia & Hiatal Hernia
Disorders of the Face, Tongue, Esophagus, Larynx, and Ear
Cricopharyngeal Dysfunction
Gastrointestinal Motility
Upper Esophageal Sphincter
Volume 2
Upper Esophageal Sphincter
Gastrointestinal Tract
Anatomy
Cricopharyngeal Dysphagia
Abstract
Esophageal Outpouchings (Diverticula)
Helpful Clues for Common Diagnoses
 https://www.sciencedirect.com/science/article/pii/B9780323477819500295
Disorders of the Face, Tongue, Esophagus, Larynx, and Ear
Michael D. Lorenz BS, DVM, DACVIM, ... Marc Kent DVM, BA, DACVIM, in Handbook of Veterinary Neurology (Fifth Edition), 2011
Cricopharyngeal Dysfunction
An uncommon cause of dysphagia involves the cricopharyngeus muscle, which together with the thyropharyngeus muscles forms the UES. Coordinated relaxation of this sphincter occurs during the pharyngoesophageal phase. Disorders involving the cricopharyngeal muscles, such as cricopharyngeal dysfunction (CD), include the inability to relax the sphincter (achalasia), delayed relaxation of the cricopharyngeus muscle as the bolus of food moves caudally (asynchrony), and failure to close the sphincter (chalasia).174 Often a combination of abnormalities is present in CD. Clinical signs consist of repeated attempts to swallow, gagging, coughing, and nasopharyngeal reflux, excessive salivation, and regurgitation, and weight loss. 175 Positive contrast-enhanced videofluoroscopic evaluation of swallowing liquids and solid food is used to confirm the diagnosis. 159,162 Using liquid barium, a mean time ±SD between closure of the epiglottis and opening of the UES is 0.09 ± 0.02 second in normal dogs. 162 The observation of a delay and/or a complete or partial obstruction in the UES is consistent with CD. Cricopharyngeal dysfunction can be acquired or congenital. Acquired CD often occurs in conjunction with other neuromuscular disorders including myasthenia gravis, laryngeal paralysis, masticatory myositis, and endocrine-associated neuromuscular disorders such as hypothyroidism. 176,177 Congenital CD has been observed in the cocker spaniel, springer spaniel, miniature poodles, and golden retriever dogs.

Cricopharyngeus Muscle - an overview | ScienceDirect Topics

Cricopharyngeus Muscle
Cricopharyngeus Muscle
The Patient with a Full Stomach
2 Upper Esophageal Sphincter Tone
Cricopharyngeal Achalasia
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
Esophagus
Cricopharyngeal Achalasia & Hiatal Hernia
Disorders of the Face, Tongue, Esophagus, Larynx, and Ear
Cricopharyngeal Dysfunction
Gastrointestinal Motility
Upper Esophageal Sphincter
Volume 2
Upper Esophageal Sphincter
Gastrointestinal Tract
Anatomy
Cricopharyngeal Dysphagia
Abstract
Esophageal Outpouchings (Diverticula)
Helpful Clues for Common Diagnoses

Cricopharyngeal Dysfunction | Columbia University Medical Center Department of Otolaryngology Head and Neck Surgery Cricopharyngeal Dysfunction
Cricopharyngeal Dysfunction
Cricopharyngeal Dysfunction
What is cricopharyngeal dysfunction?
How is cricopharyngeal dysfunction diagnosed?
How is cricopharyngeal dysfunction treated?
What is the outlook for people with cricopharyngeal dysfunction?
Make an Appointment
 In people with cricopharyngeal dysfunction, the muscle doesn’t relax, and the food is blocked from passing into the esophagus. They generally have a harder time swallowing solid foods than liquids because liquids flow more easily through the limited opening in the sphincter. The problem tends to progress gradually and slowly over time, and people with cricopharyngeal dysfunction may limit their diet to only very soft foods such as pasta or pureed foods. In severe cases, those with this disorder change their diet so drastically that they lose a lot of weight. Cricopharyngeal dysfunction is also called upper esophageal sphincter dysfunction or cricopharyngeal achalasia. How is cricopharyngeal dysfunction diagnosed? Physicians diagnose cricopharyngeal dysfunction using a number of means. A visual examination of the back of a patient’s throat will often reveal a small amount of food or saliva pooled there. They also use the following diagnostic tests: Esophageal Manometry:

In people with cricopharyngeal dysfunction, the muscle doesn’t relax, and the food is blocked from passing into the esophagus. They generally have a harder time swallowing solid foods than liquids because liquids flow more easily through the limited opening in the sphincter. The problem tends to progress gradually and slowly over time, and people with cricopharyngeal dysfunction may limit their diet to only very soft foods such as pasta or pureed foods. In severe cases, those with this disorder change their diet so drastically that they lose a lot of weight. Cricopharyngeal dysfunction is also called upper esophageal sphincter dysfunction or cricopharyngeal achalasia. How is cricopharyngeal dysfunction diagnosed? Physicians diagnose cricopharyngeal dysfunction using a number of means. A visual examination of the back of a patient’s throat will often reveal a small amount of food or saliva pooled there. They also use the following diagnostic tests: Esophageal Manometry:

Sideropenic Dysphagia in an Adolescent : Journal of Pediatric Gastroenterology and Nutrition Sideropenic Dysphagia in an Adolescent
Sideropenic Dysphagia in an Adolescent
CASE REPORT
DISCUSSION
REFERENCES
 In 1919, Paterson and Kelly (2,3) described the association of iron deficiency anemia, postcricoid dysphagia, and upper esophageal stenosis secondary to esophageal webs. Previously, Plummer (4) reported cases of esophageal spasm. In 1922, Vinson (5) reported cases with anemia and iron deficiency that he considered secondary to dysphagia. The esophageal webs are thin and transverse, protruding toward the lumen of the esophagus. They are found in the anterior wall at the level of the cricopharyngeus muscle and spread laterally; sometimes they are circumferential, manifesting normal mucosa or subepithelial inflammatory reaction or epithelial atrophy with hyperkeratosis and intense mitotic activity. They may be single or multiple (6). The etiopathogenesis of the syndrome and, more specifically, of the esophageal webs is unclear. A number of factors, such as genetic, environmental, nutritional, immunologic, and infectious, acting in concert with the iron deficiency may all play a role in the development of the syndrome (7). The diagnosis is clinical with progressive and long-standing dysphagia associated with iron deficiency anemia.

Sideropenic Dysphagia in an Adolescent : Journal of Pediatric Gastroenterology and Nutrition

Sideropenic Dysphagia in an Adolescent
Sideropenic Dysphagia in an Adolescent
CASE REPORT
DISCUSSION
REFERENCES

In 1919, Paterson and Kelly (2,3) described the association of iron deficiency anemia, postcricoid dysphagia, and upper esophageal stenosis secondary to esophageal webs. Previously, Plummer (4) reported cases of esophageal spasm. In 1922, Vinson (5) reported cases with anemia and iron deficiency that he considered secondary to dysphagia. The esophageal webs are thin and transverse, protruding toward the lumen of the esophagus. They are found in the anterior wall at the level of the cricopharyngeus muscle and spread laterally; sometimes they are circumferential, manifesting normal mucosa or subepithelial inflammatory reaction or epithelial atrophy with hyperkeratosis and intense mitotic activity. They may be single or multiple (6). The etiopathogenesis of the syndrome and, more specifically, of the esophageal webs is unclear. A number of factors, such as genetic, environmental, nutritional, immunologic, and infectious, acting in concert with the iron deficiency may all play a role in the development of the syndrome (7). The diagnosis is clinical with progressive and long-standing dysphagia associated with iron deficiency anemia.

Are the causes of this achalasia known ?
 Are the causes of this achalasia known ? Primary Motility Disorders of the Esophagus
The  Esophageal
Mucosa
The
Esophagogastric Junction
Barrett's
Esophagus

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Volume: Primary Motility Disorders of the Esophagus
Chapter: Idiopathic motor disorders of the esophagus in the elderly

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Are the causes of this achalasia known ? M. Gosselin, A. Gosselin, A. Ropert, J.F. Bretagne (Rennes)
Difficulty in swallowing can develop at any age owing to a variety of disorders such as cerebral disease, peripheral neuropathies, muscular diseases, local factors and idiopathic upper esophageal sphincter dysfunction. The latter is an extremely rare condition but it is becoming increasingly recognized particularly in the elderly in whom this dysfunction can result in severe defects in eating and nutrition. Upper esophageal sphincter (UES) dysfunction may be a part of a more generalized disorder and the mechanisms responsible for abnormalities of Cricopharyngeal function resulting in oropharyngeal dysphagia (OD) remain controversial. The various diseases listed in the table must be excluded by history, careful inspection of pharynx, hypopharynx and larynx, radiology and endoscopy, before the disorder is diagnosed as being a primary UES dysfunction. The specific defects more likely to cause OD in the aging population are strokes, Parkinson's disease, primary myositis, hyperthyroidism, cervical tumors, surgical resection of the
hypopharynx and cervical spine osteophytes.

Are the causes of this achalasia known ? Primary Motility Disorders of the Esophagus
The  Esophageal
Mucosa
The
Esophagogastric Junction
Barrett's
Esophagus

Browse by Author
Browse by Movies
OESO©2015

Volume: Primary Motility Disorders of the Esophagus
Chapter: Idiopathic motor disorders of the esophagus in the elderly

Listen
ReadSpeaker webReader: Listen
Open/close toolbar
Focus
Are the causes of this achalasia known ? M. Gosselin, A. Gosselin, A. Ropert, J.F. Bretagne (Rennes)
Difficulty in swallowing can develop at any age owing to a variety of disorders such as cerebral disease, peripheral neuropathies, muscular diseases, local factors and idiopathic upper esophageal sphincter dysfunction. The latter is an extremely rare condition but it is becoming increasingly recognized particularly in the elderly in whom this dysfunction can result in severe defects in eating and nutrition. Upper esophageal sphincter (UES) dysfunction may be a part of a more generalized disorder and the mechanisms responsible for abnormalities of Cricopharyngeal function resulting in oropharyngeal dysphagia (OD) remain controversial. The various diseases listed in the table must be excluded by history, careful inspection of pharynx, hypopharynx and larynx, radiology and endoscopy, before the disorder is diagnosed as being a primary UES dysfunction. The specific defects more likely to cause OD in the aging population are strokes, Parkinson's disease, primary myositis, hyperthyroidism, cervical tumors, surgical resection of the
hypopharynx and cervical spine osteophytes.

Cricopharyngeal dysfunction (CPD) - Laryngopedia Cricopharyngeal dysfunction (CPD)
Cricopharyngeal dysfunction (CPD)
Symptoms and treatment for cricopharyngeal dysfunction:
Photos:
Cricopharyngeal dysfunction, before and after myotomy: Series of 2  photos
Very high-pitched voice elicits the same pharynx contraction as swallowing: Series of 4  photos
Cricopharyngeal dysfunction, before and after myotomy: Series of 2  photos
Cricopharyngeal dysfunction, with incipient Zenker’s: Series of 1  photo
Reflux into hypopharynx, characteristic of cricopharyngeal dysfunction: Series of 3  photos
Cricopharyngeus non-relaxation and Zenker's sac seen during VESS: Series of 4  photos
 Cricopharyngeal dysfunction (CPD) - Laryngopedia
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Cricopharyngeal dysfunction (CPD)
Failure of the tonically contracted upper esophageal sphincter to relax and open when one swallows. Cricopharyngeal dysfunction is also known as cricopharyngeal achalasia. The cause is usually unknown. The upper esophageal sphincter is also known as the cricopharyngeus muscle and is located at the lower level of the voicebox or larynx. This muscle is always contracted except at the moment of swallowing, when it relaxes briefly to let food or liquid pass through. Symptoms and treatment for cricopharyngeal dysfunction: Typically, individuals with cricopharyngeal dysfunction first notice that pills or solid food begin to lodge at the level of the lower part of the larynx. The problem tends to progress inexorably, though often slowly, as the years pass, until the individual must limit himself or herself to liquid and soft foods. Cricopharyngeal dysfunction is fully resolved through a straightforward surgical procedure ( cricopharyngeal myotomy ), performed through the mouth with the laser or, only occasionally, through a neck incision. See also:

Cricopharyngeal dysfunction (CPD) - Laryngopedia

Cricopharyngeal dysfunction (CPD)
Cricopharyngeal dysfunction (CPD)
Symptoms and treatment for cricopharyngeal dysfunction:
Photos:
Cricopharyngeal dysfunction, before and after myotomy: Series of 2  photos
Very high-pitched voice elicits the same pharynx contraction as swallowing: Series of 4  photos
Cricopharyngeal dysfunction, before and after myotomy: Series of 2  photos
Cricopharyngeal dysfunction, with incipient Zenker’s: Series of 1  photo
Reflux into hypopharynx, characteristic of cricopharyngeal dysfunction: Series of 3  photos
Cricopharyngeus non-relaxation and Zenker's sac seen during VESS: Series of 4  photos

Cricopharyngeal dysfunction (CPD) - Laryngopedia
Home > Cricopharyngeal dysfunction (CPD)
Cricopharyngeal dysfunction (CPD)
Failure of the tonically contracted upper esophageal sphincter to relax and open when one swallows. Cricopharyngeal dysfunction is also known as cricopharyngeal achalasia. The cause is usually unknown. The upper esophageal sphincter is also known as the cricopharyngeus muscle and is located at the lower level of the voicebox or larynx. This muscle is always contracted except at the moment of swallowing, when it relaxes briefly to let food or liquid pass through. Symptoms and treatment for cricopharyngeal dysfunction: Typically, individuals with cricopharyngeal dysfunction first notice that pills or solid food begin to lodge at the level of the lower part of the larynx. The problem tends to progress inexorably, though often slowly, as the years pass, until the individual must limit himself or herself to liquid and soft foods. Cricopharyngeal dysfunction is fully resolved through a straightforward surgical procedure ( cricopharyngeal myotomy ), performed through the mouth with the laser or, only occasionally, through a neck incision. See also:

Endoscopic evaluation of esophageal motility disorders : GI Motility online
Review
Endoscopic evaluation of esophageal motility disorders
View article related content
Key Points
Introduction
Achalasia
Figure 1: a: Barium esophagram showing a dilated, tortuous esophagus and a "bird's beak" appearance of the lower esophageal sphincter ( LES ).
Figure 2: Dilated, fluid-filled esophagus in a patient with achalasia.
Figure 3: Candida esophagitis in a patient with achalasia.
Figure 4: Two examples of a puckered lower esophageal sphincter in patients with achalasia.
Scleroderma
Figure 5: Retroflexed view showing a patulous gastroesophageal junction in a patient with scleroderma.
Spastic Disorders of the Esophagus
Figure 6: A fairly normal-appearing esophagus in a patient with symptomatic nutcracker esophagus.
Esophageal Diverticula
Figure 7: Several epiphrenic diverticula in a patient with reflux esophagitis and a peptic stricture.
Figure 8: Zenker's diverticulum.
Figure 9: Barium x-ray swallowing study showing a large mid-esophageal pulsion diverticulum.
Eosinophilic Esophagitis
Figure 10: Multiple esophageal rings.
Figure 11: Fine circumferential folds, which disappear with continued air insufflation.
Other Ringed Esophagus
Conclusion
Article related content
References
 Endoscopic findings include a patulous GEJ ( Figure 5 ), esophagitis, and even Barrett's esophagus due to the hypotensive LES, stricture due to reflux, a hypotonic esophagus, or Candida esophagitis due to stasis. Although Ling and Johnston 12 found that endoscopy was not a sensitive means to evaluate the esophagus in connective tissue disease patients, especially when compared with manometry, at videoendoscopy, Cameron et al. 3 noted that the LES remained widely open in 12 of 13 patients with scleroderma. Ten of 13 scleroderma patients showed a typical motility abnormality consisting of a normal contraction in the upper esophagus and no contraction in the middle and distal esophagus. 3
Figure 5: Retroflexed view showing a patulous gastroesophageal junction in a patient with scleroderma. ( Source: Courtesy of Drew Schembre, M.D.)
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Spastic Disorders of the Esophagus
Diffuse esophageal spasm ( DES) or "corkscrew" esophagus and nutcracker esophagus are diagnosed by manometry, with DES showing abnormal simultaneous contractions in the esophageal body and nutcracker esophagus characterized by extremely high-amplitude distal esophageal contractions (mean greater than 180 mmHg). Both cause intermittent dysphagia to liquids and solids, and chest pain, which can radiate to the arms or back. The pain can be precipitated with eating, but can also occur at other times.

Endoscopic evaluation of esophageal motility disorders : GI Motility online

Review
Endoscopic evaluation of esophageal motility disorders
View article related content
Key Points
Introduction
Achalasia
Figure 1: a: Barium esophagram showing a dilated, tortuous esophagus and a "bird's beak" appearance of the lower esophageal sphincter ( LES ).
Figure 2: Dilated, fluid-filled esophagus in a patient with achalasia.
Figure 3: Candida esophagitis in a patient with achalasia.
Figure 4: Two examples of a puckered lower esophageal sphincter in patients with achalasia.
Scleroderma
Figure 5: Retroflexed view showing a patulous gastroesophageal junction in a patient with scleroderma.
Spastic Disorders of the Esophagus
Figure 6: A fairly normal-appearing esophagus in a patient with symptomatic nutcracker esophagus.
Esophageal Diverticula
Figure 7: Several epiphrenic diverticula in a patient with reflux esophagitis and a peptic stricture.
Figure 8: Zenker's diverticulum.
Figure 9: Barium x-ray swallowing study showing a large mid-esophageal pulsion diverticulum.
Eosinophilic Esophagitis
Figure 10: Multiple esophageal rings.
Figure 11: Fine circumferential folds, which disappear with continued air insufflation.
Other Ringed Esophagus
Conclusion
Article related content
References

Endoscopic findings include a patulous GEJ ( Figure 5 ), esophagitis, and even Barrett's esophagus due to the hypotensive LES, stricture due to reflux, a hypotonic esophagus, or Candida esophagitis due to stasis. Although Ling and Johnston 12 found that endoscopy was not a sensitive means to evaluate the esophagus in connective tissue disease patients, especially when compared with manometry, at videoendoscopy, Cameron et al. 3 noted that the LES remained widely open in 12 of 13 patients with scleroderma. Ten of 13 scleroderma patients showed a typical motility abnormality consisting of a normal contraction in the upper esophagus and no contraction in the middle and distal esophagus. 3
Figure 5: Retroflexed view showing a patulous gastroesophageal junction in a patient with scleroderma. ( Source: Courtesy of Drew Schembre, M.D.)
Full size image (48 KB )
Download Power Point slide (1,897 KB )
Top
of page
Spastic Disorders of the Esophagus
Diffuse esophageal spasm ( DES) or "corkscrew" esophagus and nutcracker esophagus are diagnosed by manometry, with DES showing abnormal simultaneous contractions in the esophageal body and nutcracker esophagus characterized by extremely high-amplitude distal esophageal contractions (mean greater than 180 mmHg). Both cause intermittent dysphagia to liquids and solids, and chest pain, which can radiate to the arms or back. The pain can be precipitated with eating, but can also occur at other times.

Are the causes of this achalasia known ?
 Most common among these diseases are myotonic and oculopharyngeal dystrophies, myasthenia gravis, myositis and myopathy of the thyrotoxicosis. When neurologic or muscular disease and also iatrogenic (neck operations, radiation therapy) or mechanical causes have been excluded OD can be attributed to an idiopathic dysfunction limited to the UES. Ever since its introduction in 1950 by Asherson [ 1 ], the term cricopharyngeal achalasia (CPA) has been widely accepted and indiscriminately applied to patients with a wide variety of abnormalities of UES function such as altered resting tone (hypertensive UES), abnormal relaxation (absent, incomplete or delayed relaxation) or premature closure of UES. Strictly speaking, the term CPA denotes absence of relaxation or incomplete relaxation in response to swallowing; it must be reserved for this type of UES motor disorder and the diagnosis confirmed with a high fidelity manometric device such as a low compliance system and spatially oriented manometry. Radiologists introduced the term CPA to describe a horizontal indentation that persists on the posterior wall of the pharyngoesophageal function during swallowing. This phenomenon, observed in about 5 per cent of symptomatic subjects over the age of 40 years [ 14] and 22 per cent of subjects aged 65 and over [ 12 ], has been described in a wide variety of diseases causing OD : cerebrovascular diseases, bulbar poliomyelitis, oculopharyngeal muscular dystrophy, thyroid myopathy, dermatomyositis, high unilateral vagotomy, pharyngeal diverticula and after laryngectomy [ 10 ]. As a matter of fact, the indentation does not closely correlate with UES failure to relax during manometry. Incomplete manometric relaxations have been found
in amyotrophic lateral sclerosis, neuritis, polymyositis, oculopharyngeal dystrophy, cervical osteoarthritis [ 5] and in some patients with neck surgery [ 4 ], but no recent systematic study using a high fidelity manometric device has been reported.

Belching, Bloating or fullness, Constipation and Heartburn: Common Related Medical Conditions Belching, Bloating or fullness, Constipation and Heartburn
Belching, Bloating or fullness, Constipation and Heartburn Colon cancer
Colon cancer is often asymptomatic, but it can cause constipation, bowel obstruction, bloody stool and more. Cystic fibrosis
Cystic fibrosis is an inherited disease that causes the body to produce abnormally thick and sticky mucus. Giardiasis
Giardiasis is an infection of the small intestine causing diarrhea, gas, bloating, nausea and stomach cramps. Helicobacter pylori infection
Helicobacter, bacteria in the digestive tract, causes peptic ulcers and their associated pain and burning. Diverticulosis
Diverticulosis is a condition of the colon and causes pain, cramping, infection, bleeding, and other symptoms. Kidney infection (pyelonephritis)
Kidney infection, caused by bacteria, is marked by sudden chills and fever, pain, nausea and urinary issues. Stool holding (encopresis)
Young children with encopresis soil their underwear or clothing with unintentional bowel movements. Depression (Adult)
Depression is a painful sadness that interferes with daily life and includes hopelessness, anxiety, and more. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body.

Belching, Bloating or fullness, Constipation and Heartburn: Common Related Medical Conditions

Belching, Bloating or fullness, Constipation and Heartburn
Belching, Bloating or fullness, Constipation and Heartburn

Colon cancer
Colon cancer is often asymptomatic, but it can cause constipation, bowel obstruction, bloody stool and more. Cystic fibrosis
Cystic fibrosis is an inherited disease that causes the body to produce abnormally thick and sticky mucus. Giardiasis
Giardiasis is an infection of the small intestine causing diarrhea, gas, bloating, nausea and stomach cramps. Helicobacter pylori infection
Helicobacter, bacteria in the digestive tract, causes peptic ulcers and their associated pain and burning. Diverticulosis
Diverticulosis is a condition of the colon and causes pain, cramping, infection, bleeding, and other symptoms. Kidney infection (pyelonephritis)
Kidney infection, caused by bacteria, is marked by sudden chills and fever, pain, nausea and urinary issues. Stool holding (encopresis)
Young children with encopresis soil their underwear or clothing with unintentional bowel movements. Depression (Adult)
Depression is a painful sadness that interferes with daily life and includes hopelessness, anxiety, and more. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body.

SYSTEMIC CAUSES OF DYSPHAGIA IN ADULTS - ScienceDirect SYSTEMIC CAUSES OF DYSPHAGIA IN ADULTS
Otolaryngologic Clinics of North America
SYSTEMIC CAUSES OF DYSPHAGIA IN ADULTS
DIFFERENTIAL DIAGNOSIS
Congenital
Traumatic
Neoplastic
Infections
Inflammatory
Systemic Sclerosis 1
Systemic Lupus Erythematosus 20
Dermatomyositis 5
Mixed Connective Tissue Disease 22
Benign Mucosal Pemphigoid and Epidermolysis Bullosa 2,39
Sjögren's Syndrome 9,29
Rheumatoid Arthritis 17
Secondary Autoimmune Diseases
Neurologic
Aging
Drug Induced
Other Causes of Dysphagia
Psychologic Disorders
SUMMARY
References
 Other complaints include chronic cough, throat clearing, and hoarseness. The inflammatory changes range from subtle erythema in the esophagus or larynx to severe erosive esophagitis with subsequent scarring. There is a relationship between esophagitis, Barrett's esophagus, and adenocarcinoma of the esophagus. Esophagitis is a main feature of Plummer-Vinson, or Paterson Kelly, syndrome. 28, 32, 41 The authors of this complex problem described variations of the syndrome at separate times, but the entire complex carries their names. It is most often found in women of northern European background who complain of cricopharyngeal or postcricoid dysphagia. They have atrophic gastritis, iron deficiency anemia, hypopharyngeal webs, and a high incidence of cervical esophageal cancer. Connective tissue or autoimmune diseases as a group are associated with dysphagia in a high percentage of cases. 2 The cause of the dysphagia, however, varies within the disease groups. Treatment of the basic disease, which usually requires corticosteroids or immunosuppressive agents, does not usually help the cause of the dysphagia.

SYSTEMIC CAUSES OF DYSPHAGIA IN ADULTS - ScienceDirect

SYSTEMIC CAUSES OF DYSPHAGIA IN ADULTS
Otolaryngologic Clinics of North America
SYSTEMIC CAUSES OF DYSPHAGIA IN ADULTS
DIFFERENTIAL DIAGNOSIS
Congenital
Traumatic
Neoplastic
Infections
Inflammatory
Systemic Sclerosis 1
Systemic Lupus Erythematosus 20
Dermatomyositis 5
Mixed Connective Tissue Disease 22
Benign Mucosal Pemphigoid and Epidermolysis Bullosa 2,39
Sjögren's Syndrome 9,29
Rheumatoid Arthritis 17
Secondary Autoimmune Diseases
Neurologic
Aging
Drug Induced
Other Causes of Dysphagia
Psychologic Disorders
SUMMARY
References

Other complaints include chronic cough, throat clearing, and hoarseness. The inflammatory changes range from subtle erythema in the esophagus or larynx to severe erosive esophagitis with subsequent scarring. There is a relationship between esophagitis, Barrett's esophagus, and adenocarcinoma of the esophagus. Esophagitis is a main feature of Plummer-Vinson, or Paterson Kelly, syndrome. 28, 32, 41 The authors of this complex problem described variations of the syndrome at separate times, but the entire complex carries their names. It is most often found in women of northern European background who complain of cricopharyngeal or postcricoid dysphagia. They have atrophic gastritis, iron deficiency anemia, hypopharyngeal webs, and a high incidence of cervical esophageal cancer. Connective tissue or autoimmune diseases as a group are associated with dysphagia in a high percentage of cases. 2 The cause of the dysphagia, however, varies within the disease groups. Treatment of the basic disease, which usually requires corticosteroids or immunosuppressive agents, does not usually help the cause of the dysphagia.

Cricopharyngeus Muscle - an overview | ScienceDirect Topics Cricopharyngeus Muscle
Cricopharyngeus Muscle
The Patient with a Full Stomach
2 Upper Esophageal Sphincter Tone
Cricopharyngeal Achalasia
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
Esophagus
Cricopharyngeal Achalasia & Hiatal Hernia
Disorders of the Face, Tongue, Esophagus, Larynx, and Ear
Cricopharyngeal Dysfunction
Gastrointestinal Motility
Upper Esophageal Sphincter
Volume 2
Upper Esophageal Sphincter
Gastrointestinal Tract
Anatomy
Cricopharyngeal Dysphagia
Abstract
Esophageal Outpouchings (Diverticula)
Helpful Clues for Common Diagnoses
 Sign in to download full-size image
Esophagus
Pharynx
Indentation from cricopharyngeus muscle
The cricopharyngeus normally relaxes in anticipation of the arrival of a bolus of food. This lateral film shows persistent filling of the pharynx and contraction of the cricopharyngeus muscle after the bolus of barium has passed. Sign in to download full-size image
Esophagus
Herniated stomach
Diaphragm
Film of the lower chest in the same patient shows a hiatal hernia. Cricopharyngeal achalasia is often the indirect result of disordered esophageal motility and acid reflux. View chapter Purchase book
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URL: https://www.sciencedirect.com/science/article/pii/B9780323477819500295
Disorders of the Face, Tongue, Esophagus, Larynx, and Ear
Michael D. Lorenz BS, DVM, DACVIM, ... Marc Kent DVM, BA, DACVIM, in Handbook of Veterinary Neurology (Fifth Edition), 2011
Cricopharyngeal Dysfunction
An uncommon cause of dysphagia involves the cricopharyngeus muscle, which together with the thyropharyngeus muscles forms the UES. Coordinated relaxation of this sphincter occurs during the pharyngoesophageal phase. Disorders involving the cricopharyngeal muscles, such as cricopharyngeal dysfunction (CD), include the inability to relax the sphincter (achalasia), delayed relaxation of the cricopharyngeus muscle as the bolus of food moves caudally (asynchrony), and failure to close the sphincter (chalasia).174 Often a combination of abnormalities is present in CD. Clinical signs consist of repeated attempts to swallow, gagging, coughing, and nasopharyngeal reflux, excessive salivation, and regurgitation, and weight loss. 175 Positive contrast-enhanced videofluoroscopic evaluation of swallowing liquids and solid food is used to confirm the diagnosis.

Cricopharyngeus Muscle - an overview | ScienceDirect Topics Cricopharyngeus Muscle
Cricopharyngeus Muscle
The Patient with a Full Stomach
2 Upper Esophageal Sphincter Tone
Cricopharyngeal Achalasia
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
Esophagus
Cricopharyngeal Achalasia & Hiatal Hernia
Disorders of the Face, Tongue, Esophagus, Larynx, and Ear
Cricopharyngeal Dysfunction
Gastrointestinal Motility
Upper Esophageal Sphincter
Volume 2
Upper Esophageal Sphincter
Gastrointestinal Tract
Anatomy
Cricopharyngeal Dysphagia
Abstract
Esophageal Outpouchings (Diverticula)
Helpful Clues for Common Diagnoses
 34-38
View chapter Purchase book
Read full chapter
URL: https://www.sciencedirect.com/science/article/pii/B978143772764700035X
Cricopharyngeal Achalasia
In Imaging in Gastroenterology, 2018
KEY FACTS
Terminology
•
Failure of cricopharyngeal muscle (upper esophageal sphincter) relaxation due to hypertrophy or spasm
Imaging
•
Prominent cricopharyngeus muscle at pharyngoesophageal junction with retention of barium in pharynx on lateral view
○
Pharyngoesophageal junction: C5-C6 level
•
Videofluoroscopic recording: Frontal, lateral, and oblique
○
Rapid sequence filming required for demonstration
Top Differential Diagnoses
•
Cervical osteophytes (indentation)
○
Large anterior cervical osteophytes can impinge on pharyngoesophageal junction, simulating cricopharyngeal achalasia
•
Esophageal tumor
○
Tumor at pharyngoesophageal junction may constrict lumen concentrically or eccentrically
Pathology
•
Usually just "poor timing" of cricopharyngeal contraction
○
Due to "presbyesophagus" or other cause of dysmotility in most cases
•
May occur as isolated abnormality
Clinical Issues
•
Intermittent symptoms: Dysphagia, food "sticking" in throat (at suprasternal level)
•
Treat underlying problem
○
e.g., reflux esophagitis with spasm
•
Rarely requires cricopharyngeal myotomy or botulinum toxin injection
Diagnostic Checklist
•
Persistent narrowing or just intermittent indentation
•
Smoothly outlined, lip-like projection posteriorly at C5-C6 level with jet effect seen via narrowed lumen
View chapter Purchase book
Read full chapter
URL: https://www.sciencedirect.com/science/article/pii/B9780323554084500641
Esophagus
In Imaging Anatomy: Chest, Abdomen, Pelvis (Second Edition), 2017
Cricopharyngeal Achalasia & Hiatal Hernia
Sign in to download full-size image
Pharynx
Esophagus
C5 vertebra
Indentation from cricopharyngeus muscle
First of 3 films from a barium esophagram is shown. This lateral view shows a rounded indentation of the posterior wall of the pharyngoesophageal junction at the level of the disc space between the 5th and 6th cervical vertebrae. The pharynx is distended, indicating impaired passage of the barium. These are typical features of spasm or achalasia (failure to relax) of the cricopharyngeus muscle, which is part of the upper esophageal sphincter.

Cricopharyngeal Bar Dysphagia Treated Successfully with Endo... : Official journal of the American College of Gastroenterology | ACG Cricopharyngeal Bar Dysphagia Treated Successfully with Endoscopic Dilation
Cricopharyngeal Bar Dysphagia Treated Successfully with Endoscopic Dilation
432
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Abstracts: CLINICAL VIGNETTES/CASE REPORTS - ESOPHAGUS
Cricopharyngeal Bar Dysphagia Treated Successfully with Endoscopic Dilation
432
Upchurch, Bennie MD, FACG
Author Information
Internal Medicine, Creighton University, Omaha, NE. American Journal of Gastroenterology: October 2011 - Volume 106 - Issue - p S169
Free
Purpose: Cricopharyngeal (CP) bar is an uncommon but important cause for dysphagia.

Cricopharyngeal Bar Dysphagia Treated Successfully with Endo... : Official journal of the American College of Gastroenterology | ACG

Cricopharyngeal Bar Dysphagia Treated Successfully with Endoscopic Dilation
Cricopharyngeal Bar Dysphagia Treated Successfully with Endoscopic Dilation
432

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Abstracts: CLINICAL VIGNETTES/CASE REPORTS - ESOPHAGUS
Cricopharyngeal Bar Dysphagia Treated Successfully with Endoscopic Dilation
432
Upchurch, Bennie MD, FACG
Author Information
Internal Medicine, Creighton University, Omaha, NE. American Journal of Gastroenterology: October 2011 - Volume 106 - Issue - p S169
Free
Purpose: Cricopharyngeal (CP) bar is an uncommon but important cause for dysphagia.

 Results
The UES sagittal diameter increased from 5.6 mm pre-operatively to 8.4 mm 6 months post-operatively with no differences between treatment groups. Preoperative mean Sydney Swallowing Questionnaire score was 770 and 6 months post-operative score 559, with no difference between the treatments in our cohort. Conclusion
Cricopharyngeal dysfunction treatment by either laser myotomy or balloon dilatation improved upper oesophageal sphincter opening during at least 6 months. Trial registration: ISRCTN84905610, date: 081214
Keywords: Cricopharyngeal dysfunction, Upper oesophageal sphincter, Cricopharyngeus muscle, Videomanometry, Sydney Swallowing Questionnaire
Background
The pharyngoesophageal segment (PES) is made up of the inferior pharyngeal constrictor, the cricopharyngeus muscle (CPM) and the proximal part of the cervical oesophagus. The upper oesophageal sphincter (UES) is a 2.5–4.5 cm high-pressure zone visualized on manometry between the pharynx and oesophagus. PES refers to anatomy and UES to function, but the terms are synonymous. The CPM is 1–2 cm and it is a key component of the UES because it is the only portion that actively participates in all reflexive relaxation and tightening activities [1].

Results
The UES sagittal diameter increased from 5.6 mm pre-operatively to 8.4 mm 6 months post-operatively with no differences between treatment groups. Preoperative mean Sydney Swallowing Questionnaire score was 770 and 6 months post-operative score 559, with no difference between the treatments in our cohort. Conclusion
Cricopharyngeal dysfunction treatment by either laser myotomy or balloon dilatation improved upper oesophageal sphincter opening during at least 6 months. Trial registration: ISRCTN84905610, date: 081214
Keywords: Cricopharyngeal dysfunction, Upper oesophageal sphincter, Cricopharyngeus muscle, Videomanometry, Sydney Swallowing Questionnaire
Background
The pharyngoesophageal segment (PES) is made up of the inferior pharyngeal constrictor, the cricopharyngeus muscle (CPM) and the proximal part of the cervical oesophagus. The upper oesophageal sphincter (UES) is a 2.5–4.5 cm high-pressure zone visualized on manometry between the pharynx and oesophagus. PES refers to anatomy and UES to function, but the terms are synonymous. The CPM is 1–2 cm and it is a key component of the UES because it is the only portion that actively participates in all reflexive relaxation and tightening activities [1].

Anatomy & Physiology of Swallowing - UC Davis Center for Voice and SwallowingUC Davis Center for Voice and Swallowing Anatomy & Physiology of Swallowing
Anatomy & Physiology of Swallowing
Oral Phase
Pharyngeal Phase
Esophageal Phase
 In certain patients, however, the cough response may be diminished and aspiration may occur without any warning at all. This is referred to as “silent aspiration”. Silent aspiration is very dangerous and may result in aspiration pneumonia or even death. Therefore, the trained swallowing specialist does not rely on the presence of coughing alone when assessing the patient’s swallowing function and will often request further diagnostic testing, such as a modified barium swallow or endoscopic evaluation of swallowing. The cricopharyngeus muscle, also referred to as the upper esophageal sphincter (UES), may occassionally malfunction. It may be hypertonic, fail to relax, or work in a discoordinated fashion. UES dysfunction can cause dysphagia, weight loss, a sensation of food getting stuck in the throat, and aspiration. Appropriate relaxation of the UES is essential to the normal swallowing mechanism. Abnormalities can be evaluated by UES manometry. Treatment may be chemical (Botox) or surgical.

Anatomy & Physiology of Swallowing - UC Davis Center for Voice and SwallowingUC Davis Center for Voice and Swallowing

Anatomy & Physiology of Swallowing
Anatomy & Physiology of Swallowing
Oral Phase
Pharyngeal Phase
Esophageal Phase

In certain patients, however, the cough response may be diminished and aspiration may occur without any warning at all. This is referred to as “silent aspiration”. Silent aspiration is very dangerous and may result in aspiration pneumonia or even death. Therefore, the trained swallowing specialist does not rely on the presence of coughing alone when assessing the patient’s swallowing function and will often request further diagnostic testing, such as a modified barium swallow or endoscopic evaluation of swallowing. The cricopharyngeus muscle, also referred to as the upper esophageal sphincter (UES), may occassionally malfunction. It may be hypertonic, fail to relax, or work in a discoordinated fashion. UES dysfunction can cause dysphagia, weight loss, a sensation of food getting stuck in the throat, and aspiration. Appropriate relaxation of the UES is essential to the normal swallowing mechanism. Abnormalities can be evaluated by UES manometry. Treatment may be chemical (Botox) or surgical.

Pulmonary Aspiration - an overview | ScienceDirect Topics Pulmonary Aspiration
Pulmonary Aspiration
Pulmonary Aspiration
Implications
The Patient with a Full Stomach
II Definition of Pulmonary Aspiration
Perioperative Aspiration Pneumonitis
Risk Assessment
Anaesthesia and neuromuscular block
Gastric contents
Respiratory medicine
Aspiration Syndromes
Acute Respiratory Failure
Aspiration
Complications of Managing the Airway
G Aspiration
Nosocomial Respiratory Infections
Role of Endotracheal Tube
Acute alveolar injury and repair
Aspiration of gastric contents
 Metoclopramide usefully hastens gastric emptying, increases the tone of the lower oesophageal sphincter and is an antiemetic. View chapter Purchase book
Read full chapter
URL: https://www.sciencedirect.com/science/article/pii/B9780702040849000586
Respiratory medicine
ProfessorCrispian Scully CBE, MD, PhD, MDS, MRCS, FDSRCS, FDSRCPS, FFDRCSI, FDSRCSE, FRCPath, FMedSci, FHEA, FUCL, FBS, DSc, DChD, DMed (HC), Dr (hc), in Scully's Medical Problems in Dentistry (Seventh Edition), 2014
Aspiration Syndromes
Aspiration syndromes are conditions in which foreign substances are inhaled into the lungs and which can have consequences ranging from asphyxia to infection and lung abscess. Dental restorations or fragments of teeth, plaque, gastric contents and other materials may be aspirated, especially if material enters the pharynx, and particularly if the cough reflex is impaired for any reason. Most commonly, aspiration syndromes involve oral or gastric contents associated with gastro-oesophageal reflux disease (GORD), swallowing dysfunction (Ch. 7), neurological disorders and structural abnormalities, such as a pharyngeal pouch. Cricopharyngeal dysfunction involves cricopharyngeal muscle spasm or achalasia of the superior oesophageal sphincter, and can be seen in infants who have a normal sucking reflex but have incoordination during swallowing, possibly secondary to delayed development or cerebral palsy. Anatomical disorders, such as cleft palate, pharyngeal pouch, oesophageal atresia, tracheo-oesophageal fistula, duodenal obstruction or malrotation, and motility disorders, such as achalasia, may have an aspiration risk. Infirm older patients are also at risk of aspiration, especially if they are bed-bound or have neurological disorders. Isolated superior laryngeal nerve damage, vocal cord paralysis, cerebral palsy, muscular dystrophy and Riley–Day syndrome (familial dysautonomia) are all associated with increased risk of aspiration.

Pulmonary Aspiration - an overview | ScienceDirect Topics

Pulmonary Aspiration
Pulmonary Aspiration
Pulmonary Aspiration
Implications
The Patient with a Full Stomach
II Definition of Pulmonary Aspiration
Perioperative Aspiration Pneumonitis
Risk Assessment
Anaesthesia and neuromuscular block
Gastric contents
Respiratory medicine
Aspiration Syndromes
Acute Respiratory Failure
Aspiration
Complications of Managing the Airway
G Aspiration
Nosocomial Respiratory Infections
Role of Endotracheal Tube
Acute alveolar injury and repair
Aspiration of gastric contents

 081214
Keywords: Cricopharyngeal dysfunction, Upper oesophageal sphincter, Cricopharyngeus muscle, Videomanometry, Sydney Swallowing Questionnaire
Background
The pharyngoesophageal segment (PES) is made up of the inferior pharyngeal constrictor, the cricopharyngeus muscle (CPM) and the proximal part of the cervical oesophagus. The upper oesophageal sphincter (UES) is a 2.5–4.5 cm high-pressure zone visualized on manometry between the pharynx and oesophagus. PES refers to anatomy and UES to function, but the terms are synonymous. The CPM is 1–2 cm and it is a key component of the UES because it is the only portion that actively participates in all reflexive relaxation and tightening activities [1]. Cricopharyngeal dysfunction (CPD), characterized by oropharyngeal dysphagia, may be due to incoordination as well as reduction in maximal opening of the UES during transphincteric flow [2, 3]. Radiological assessment of CPD can be challenging [3]. Videomanometry (VM) combining solid state manometry and videofluoroscopy allows direct comparison of pressure readings with dynamic anatomy giving a better appreciation of how these readings are related to the passage of the bolus [4, 5]. The CPM is frequently targeted for intervention in CPD [6]. There are four approaches to the CPM, including:

081214
Keywords: Cricopharyngeal dysfunction, Upper oesophageal sphincter, Cricopharyngeus muscle, Videomanometry, Sydney Swallowing Questionnaire
Background
The pharyngoesophageal segment (PES) is made up of the inferior pharyngeal constrictor, the cricopharyngeus muscle (CPM) and the proximal part of the cervical oesophagus. The upper oesophageal sphincter (UES) is a 2.5–4.5 cm high-pressure zone visualized on manometry between the pharynx and oesophagus. PES refers to anatomy and UES to function, but the terms are synonymous. The CPM is 1–2 cm and it is a key component of the UES because it is the only portion that actively participates in all reflexive relaxation and tightening activities [1]. Cricopharyngeal dysfunction (CPD), characterized by oropharyngeal dysphagia, may be due to incoordination as well as reduction in maximal opening of the UES during transphincteric flow [2, 3]. Radiological assessment of CPD can be challenging [3]. Videomanometry (VM) combining solid state manometry and videofluoroscopy allows direct comparison of pressure readings with dynamic anatomy giving a better appreciation of how these readings are related to the passage of the bolus [4, 5]. The CPM is frequently targeted for intervention in CPD [6]. There are four approaches to the CPM, including:

Heartburn, Itching or burning, Itching or burning and Pain or discomfort: Common Related Medical Conditions Heartburn, Itching or burning (Scalp), Itching or burning (Ears) and Pain or discomfort
Heartburn, Itching or burning (Scalp), Itching or burning (Ears) and Pain or discomfort Esophageal spasm
Esophageal spasms are sudden, painful contractions in the muscles of the esophagus. Foreign object in the ear canal
A foreign object in the ear may cause pain, redness, drainage problems, and in rare case, hearing loss. Dermatitis
Dermatitis is any inflammation of the skin that causes a rash, which may cause itching, redness, and more. Poison ivy, oak, and sumac
The toxin found in poison ivy, oak, and sumac causes an itchy, allergic rash with raised welts and blisters. Osteomyelitis (bone infection)
Osteomyelitis is an infection of a bone that causes pain, swelling, and redness. Obesity
Obesity is having too much body fat, marked by a BMI of 30 or higher. Dupuytren's contracture
Dupuytren's contracture is a condition of the hand tissue that causes the fingers to curl. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Hyperparathyroidism
Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body.

Heartburn, Itching or burning, Itching or burning and Pain or discomfort: Common Related Medical Conditions

Heartburn, Itching or burning (Scalp), Itching or burning (Ears) and Pain or discomfort
Heartburn, Itching or burning (Scalp), Itching or burning (Ears) and Pain or discomfort

Esophageal spasm
Esophageal spasms are sudden, painful contractions in the muscles of the esophagus. Foreign object in the ear canal
A foreign object in the ear may cause pain, redness, drainage problems, and in rare case, hearing loss. Dermatitis
Dermatitis is any inflammation of the skin that causes a rash, which may cause itching, redness, and more. Poison ivy, oak, and sumac
The toxin found in poison ivy, oak, and sumac causes an itchy, allergic rash with raised welts and blisters. Osteomyelitis (bone infection)
Osteomyelitis is an infection of a bone that causes pain, swelling, and redness. Obesity
Obesity is having too much body fat, marked by a BMI of 30 or higher. Dupuytren's contracture
Dupuytren's contracture is a condition of the hand tissue that causes the fingers to curl. Barrett esophagus
Barrett's esophagus occurs when the lining of the esophagus is damaged, usually by acid reflux. Hyperparathyroidism
Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more. CREST syndrome
CREST syndrome is a rare autoimmune disease that causes tissues to harden throughout the body.

Lump In Throat (Throat Fullness, Globus Syndrome, Globus Sensation, Globus Hystericus, Globus Pharyngeus) | Iowa Head and Neck Protocols Lump In Throat (Throat Fullness, Globus Syndrome, Globus Sensation, Globus Hystericus, Globus Pharyngeus)
Lump In Throat (Throat Fullness, Globus Syndrome, Globus Sensation, Globus Hystericus, Globus Pharyngeus)
See also: Esophageal Reflux Precautions
TERMINOLOGY
HISTORY
EPIDEMIOLOGY
ANATOMY
ETIOLOGIES (PATHOGENESIS)
DIFFERENTIAL DIAGNOSIS  OF GLOBUS SYMPTOMS
EVALUATION
MANAGEMENT
Proposed algorithm for evaluation and management of globus:
PROGNOSIS
RECOMMENDED READING
REFERENCES
 2004)
Upper esophagus disorders
Esophageal inlet patch (heterotopic gastric mucosa at UES)
Hypertensive upper esophageal sphincter
Zenker's diverticulum
Mass (tumor) in the tongue base including thyroglossal duct cyst (Li 2019)
Iatrogenic (head and neck surgery- uvulopalatopharyngoplasty )
Eosinophilic/pill esophagitis
EVALUATION
Rome IV Diagnostic Criteria for Globus Syndrome (a functional gastrointestinal disorder)*
All criteria must be present for the past 3 months with symptom onset at least 6 months prior to diagnosis of globus. Must have symptoms at least once per week. Persistent or intermittent, nonpainful, sensation of a lump or foreign body in the throat with no structural lesion identified on physical examination, laryngoscopy, or endoscopy. Occurrence of the sensation between meals. Absence of dysphagia or odynophagia. Absence of a gastric inlet patch in the proximal esophagus. Absence of evidence that gastroesophageal reflux or eosinophilic esophagitis is the cause of the symptom. Absence of major esophageal motor disorders (achalasia/ esophagogastric junction outflow obstruction, diffuse esophageal spasm, jackhammer esophagus, absent peristalsis)
*Rome IV criteria are sets of diagnostic criteria for determining functional gastrointestinal disorders (e.g., irritable bowel syndrome, nausea/vomiting syndromes, globus, functional heartburn, etc.) set by the Rome Foundation
The Rome Foundation is an independent not-for-profit organizati

Lump In Throat (Throat Fullness, Globus Syndrome, Globus Sensation, Globus Hystericus, Globus Pharyngeus) | Iowa Head and Neck Protocols

Lump In Throat (Throat Fullness, Globus Syndrome, Globus Sensation, Globus Hystericus, Globus Pharyngeus)
Lump In Throat (Throat Fullness, Globus Syndrome, Globus Sensation, Globus Hystericus, Globus Pharyngeus)
See also: Esophageal Reflux Precautions
TERMINOLOGY
HISTORY
EPIDEMIOLOGY
ANATOMY
ETIOLOGIES (PATHOGENESIS)
DIFFERENTIAL DIAGNOSIS  OF GLOBUS SYMPTOMS
EVALUATION
MANAGEMENT
Proposed algorithm for evaluation and management of globus:
PROGNOSIS
RECOMMENDED READING
REFERENCES

2004)
Upper esophagus disorders
Esophageal inlet patch (heterotopic gastric mucosa at UES)
Hypertensive upper esophageal sphincter
Zenker's diverticulum
Mass (tumor) in the tongue base including thyroglossal duct cyst (Li 2019)
Iatrogenic (head and neck surgery- uvulopalatopharyngoplasty )
Eosinophilic/pill esophagitis
EVALUATION
Rome IV Diagnostic Criteria for Globus Syndrome (a functional gastrointestinal disorder)*
All criteria must be present for the past 3 months with symptom onset at least 6 months prior to diagnosis of globus. Must have symptoms at least once per week. Persistent or intermittent, nonpainful, sensation of a lump or foreign body in the throat with no structural lesion identified on physical examination, laryngoscopy, or endoscopy. Occurrence of the sensation between meals. Absence of dysphagia or odynophagia. Absence of a gastric inlet patch in the proximal esophagus. Absence of evidence that gastroesophageal reflux or eosinophilic esophagitis is the cause of the symptom. Absence of major esophageal motor disorders (achalasia/ esophagogastric junction outflow obstruction, diffuse esophageal spasm, jackhammer esophagus, absent peristalsis)
*Rome IV criteria are sets of diagnostic criteria for determining functional gastrointestinal disorders (e.g., irritable bowel syndrome, nausea/vomiting syndromes, globus, functional heartburn, etc.) set by the Rome Foundation
The Rome Foundation is an independent not-for-profit organizati

LearningRadiology - esophageal, web, esophagus, plummer, vinson, syndrome, patterson, kelly, dysphagia, radiology, barium Esophageal Web
 LearningRadiology - esophageal, web, esophagus, plummer, vinson, syndrome, patterson, kelly, dysphagia, radiology, barium

Sidebar

Esophageal Web
General Considerations
Mucosal shelf projecting into the lumen of the esophagus most frequently from the anterior wall of proximal cervical esophagus at the level of cricopharyngeus (C5-C6)
Uncommon in distal esophagus
Usually seen in middle-aged adults, females greater than males
May or may not contain submucosa
Cervical webs may be congenital, idiopathic (normal variant) or due to prior inflammation and scarring
Distal esophageal webs are usually the sequelae of inflammation such as from EG reflux
Clinical Findings
Mostly asymptomatic
May present with dysphagia
Food may impact above web
Imaging Findings
May be shelf-like to circumferential in proximal cervical esophagus on swallowing study
Most easily seen on videofluoroscopic esophagram, usually in lateral projection
1-2 mm wide
Luminal narrowing may be absent or severe
Differential Diagnoses
Esophageal strictures
Longer than webs
Schatzki ring
Lower (GE junction) esophageal mucosal or Β ring
Cricopharyngeal achalasia
Larger, rounded protrusion from posterior pharyngeal wall at pharyngoesophageal junction (C5-6 level)
Associations
May be associated with Plummer-Vinson (Paterson-Kelly) syndrome
Eosinophilic esophagitis
Celiac-sprue disease
Chronic gastroesophageal reflux
Treatment
Balloon dilation or bougienage during esophagoscopy
Prognosis
Good
Cervical esophageal web. There is a linear, shelf-like filling defect (white arrow)
on the anterior aspect of the cervical esophagus at the level of C5-C6 on this still frame of a video swallowing function study. For this same photo without the arrow, click here
For more information, click on the link if you see this icon
Rees CJ et al: Upper esophageal web. Ear Nose Throat J. 86 (12):732, 2007
Nosher JL et al: The clinical significance of cervical esophageal and hypopharyngeal webs. Radiology. 117 (1):45-7, 1975
Clements JL Jr et al: Cervical esophageal webs--a roentgen anatomic correlation. Observations on the pharyngoesophagus.

LearningRadiology - esophageal, web, esophagus, plummer, vinson, syndrome, patterson, kelly, dysphagia, radiology, barium

Cricopharyngeal achalasia - MediGoo - Health Tests and Medical Info Cricopharyngeal achalasia
Cricopharyngeal achalasia Cricopharyngeal achalasia - MediGoo - Health Tests and Medical Info
Cricopharyngeal achalasia
Cricopharyngeal achalasia: Description, Causes and Risk Factors: Functional obstruction at the level of the upper esophageal sphincter due to failure of relaxation of the cricopharyngeal muscles; often associated with a pharyngoesophageal diverticulum. Cricopharyngeal achalasia is a disorder characterized by an abnormal pattern of deglutitive inhibition of tone in the cricopharyngeus muscle. The condition is distinct from abnormalities of the normal relaxation response to the esophageal air distention and elevated resting tone. Diverse etiologies may cause the disorder, and a sequence of tests is usually necessary to confirm the diagnosis and exclude other conditions that might cause similar symptoms. Guidance on treatment options is limited due to the lack of controlled trials for the disorder as well as concern about accuracy of the diagnosis. Asherson was the first to consider the possibility that defective opening of the upper esophageal sphincter (UES) might cause swallowing problems. He describes in his study several patients with a characteristic profile radiograph of the pharynx:

Cricopharyngeal achalasia - MediGoo - Health Tests and Medical Info

Cricopharyngeal achalasia
Cricopharyngeal achalasia

Cricopharyngeal achalasia - MediGoo - Health Tests and Medical Info
Cricopharyngeal achalasia
Cricopharyngeal achalasia: Description, Causes and Risk Factors: Functional obstruction at the level of the upper esophageal sphincter due to failure of relaxation of the cricopharyngeal muscles; often associated with a pharyngoesophageal diverticulum. Cricopharyngeal achalasia is a disorder characterized by an abnormal pattern of deglutitive inhibition of tone in the cricopharyngeus muscle. The condition is distinct from abnormalities of the normal relaxation response to the esophageal air distention and elevated resting tone. Diverse etiologies may cause the disorder, and a sequence of tests is usually necessary to confirm the diagnosis and exclude other conditions that might cause similar symptoms. Guidance on treatment options is limited due to the lack of controlled trials for the disorder as well as concern about accuracy of the diagnosis. Asherson was the first to consider the possibility that defective opening of the upper esophageal sphincter (UES) might cause swallowing problems. He describes in his study several patients with a characteristic profile radiograph of the pharynx:

Cricopharyngeal | definition of cricopharyngeal by Medical dictionary cricopharyngeal
cricopharyngeal
cricopharyngeal
pertaining to the cricoid cartilage and pharynx.
cri·co·pha·ryn·ge·al
cri·co·pha·ryn·ge·al
Mentioned in ?
References in periodicals archive ?
Medical browser ?
Full browser ?
 Botulinum toxin for cricopharyngeal dysfunction in Parkinson's disease. Botulinum toxin: Emerging psychiatric indications: Botulinum toxin has shown promising antidepressant effects, and might be helpful for several other indications
Foreign bodies get lodged in any of the three narrow points in the oesophagus: the cricopharyngeal area, the middle third of the oesophagus where the aortic arch and left main bronchus cross the oesophagus or the lower oesophageal sphincter. Novel technique for endoscopic retrieval of a ring-shaped gastric foreign body
Decreased pharyngeal peristalsis and cricopharyngeal relaxation were noted. Deaths associated with insertion of nasogastric tubes for enteral nutrition in the medical intensive care unit: Clinical and autopsy findings
Given the inability to find the nerve in its usual location and after assessing the anatomical landmarks used to this effect, the retrograde dissection is useful, i.e., from the entrance of the nerve to the larynx below the fascicles of the cricopharyngeal portion of the inferior constrictor, always taking the possibility of its extralaryngeal division into consideration (Ngo Nyeki et al.). Prevalence of the Right Nonrecurrent Inferior Laryngeal Nerve in a Series of 100 Total Thyroidectomies/Prevalencia del Nervio Laringeo Inferior Derecho no Recurrente en una Serie de 100 Tiroidectomias Totales
Other potential etiologies for this symptom include gastroesophageal reflux disease, postnasal drip, cricopharyngeal spasm, lingual tonsil hypertrophy, cervical osteophytes, and malignancy [5, 6]. Delayed Presentation of Submucosal Retained Toothbrush from Self-Inflicted Injury in Patient with Schizophrenia
The various mechanisms of dysphagia are mechanical compression causing esophageal obstruction, pharyngoesophageal irritation, and a local inflammatory response resulting in cricopharyngeal spasm and esophageal denervation [8].

Cricopharyngeal | definition of cricopharyngeal by Medical dictionary

cricopharyngeal
cricopharyngeal
cricopharyngeal
pertaining to the cricoid cartilage and pharynx.
cri·co·pha·ryn·ge·al
cri·co·pha·ryn·ge·al
Mentioned in ?
References in periodicals archive ?
Medical browser ?
Full browser ?

Cricopharyngeal | definition of cricopharyngeal by Medical dictionary cricopharyngeal
cricopharyngeal
cricopharyngeal
pertaining to the cricoid cartilage and pharynx.
cri·co·pha·ryn·ge·al
cri·co·pha·ryn·ge·al
Mentioned in ?
References in periodicals archive ?
Medical browser ?
Full browser ?
 Novel technique for endoscopic retrieval of a ring-shaped gastric foreign body
Decreased pharyngeal peristalsis and cricopharyngeal relaxation were noted. Deaths associated with insertion of nasogastric tubes for enteral nutrition in the medical intensive care unit: Clinical and autopsy findings
Given the inability to find the nerve in its usual location and after assessing the anatomical landmarks used to this effect, the retrograde dissection is useful, i.e., from the entrance of the nerve to the larynx below the fascicles of the cricopharyngeal portion of the inferior constrictor, always taking the possibility of its extralaryngeal division into consideration (Ngo Nyeki et al.). Prevalence of the Right Nonrecurrent Inferior Laryngeal Nerve in a Series of 100 Total Thyroidectomies/Prevalencia del Nervio Laringeo Inferior Derecho no Recurrente en una Serie de 100 Tiroidectomias Totales
Other potential etiologies for this symptom include gastroesophageal reflux disease, postnasal drip, cricopharyngeal spasm, lingual tonsil hypertrophy, cervical osteophytes, and malignancy [5, 6]. Delayed Presentation of Submucosal Retained Toothbrush from Self-Inflicted Injury in Patient with Schizophrenia
The various mechanisms of dysphagia are mechanical compression causing esophageal obstruction, pharyngoesophageal irritation, and a local inflammatory response resulting in cricopharyngeal spasm and esophageal denervation [8]. Pyogenic Spondylitis Caused by Methicillin-Resistant Staphylococcus aureus Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament
The transport of bolus into the esophagus depends to a greater extent on the coordination between cricopharyngeal muscles, UES, and upper esophagus (10,11). Patulous upper esophageal sphincter - an unusual endoscopic finding
The sharp metal parts of the tooth were lodged in the cricopharyngeal narrowness. Foreign body in the stomach: Dentures
Usually, the foreign bodies are stuck at an inch below the cricopharyngeal sphincter because strong propulsive pharyngeal muscles can force an object up to that level and further down the oesophageal musculature cannot propel the foreign body with the same intensity. Effectiveness of plain X-ray in detection of fish and chicken bone foreign body in upper aerodigestive tract
Messner, "The use of botulinum toxin for pediatric cricopharyngeal achalasia," International Journal of Pediatric Otorhinolaryngology, vol.

Swallowing - Cure IBM Inclusion Body Myositis – Dysphagia, or Difficulty Swallowing
Inclusion Body Myositis – Dysphagia, or Difficulty Swallowing
The Significance of Dysphagia in IBM
The Mechanics of Normal Swallowing
Video of Swallowing Mechanics
Family and Friends Should Know How to Assist in a Choking Emergency
How is Swallowing Evaluated?
Video of Barium swallow
Causes of Dysphagia in Inclusion Body Myositis
Video of Cricopharyngeal dysfunction
Treatment of Dysphagia in IBM
Video of Cricopharyngeal dysfunction: Before and After Cricopharyngeal Myotomy
Video of Feeding Tube Procedure
 They should learn the recommended ways to assist in a choking emergency. Mayo Clinic advise regarding choking first aid
American Red Cross summary of choking first aid (printable, one page PDF)
How is Swallowing Evaluated? Swallowing is evaluated by speech therapists who have expertise in swallowing. A VideoFluoroscopic Swallowing Study (VFSS), also called a modified barium swallow, may be ordered. The patient swallows a substance called barium that blocks x-rays. During swallowing, x-rays allows the throat to be seen on a video monitor, and the passage of barium from the mouth down into the stomach is observed. A Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is done by inserting a camera-equipped tube through the nose into the throat so that swallowing can be viewed. Video of Barium swallow
Causes of Dysphagia in Inclusion Body Myositis
Cricopharyngeus muscle dysfunction is often responsible for swallowing difficulties. The cricopharngeus muscle, located in the upper throat, is also known as the upper esophageal sphincter. It relaxes during normal swallowing, opening up the esophagus so food can pass.

Swallowing - Cure IBM

Inclusion Body Myositis – Dysphagia, or Difficulty Swallowing
Inclusion Body Myositis – Dysphagia, or Difficulty Swallowing
The Significance of Dysphagia in IBM
The Mechanics of Normal Swallowing
Video of Swallowing Mechanics
Family and Friends Should Know How to Assist in a Choking Emergency
How is Swallowing Evaluated?
Video of Barium swallow
Causes of Dysphagia in Inclusion Body Myositis
Video of Cricopharyngeal dysfunction
Treatment of Dysphagia in IBM
Video of Cricopharyngeal dysfunction: Before and After Cricopharyngeal Myotomy
Video of Feeding Tube Procedure

They should learn the recommended ways to assist in a choking emergency. Mayo Clinic advise regarding choking first aid
American Red Cross summary of choking first aid (printable, one page PDF)
How is Swallowing Evaluated? Swallowing is evaluated by speech therapists who have expertise in swallowing. A VideoFluoroscopic Swallowing Study (VFSS), also called a modified barium swallow, may be ordered. The patient swallows a substance called barium that blocks x-rays. During swallowing, x-rays allows the throat to be seen on a video monitor, and the passage of barium from the mouth down into the stomach is observed. A Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is done by inserting a camera-equipped tube through the nose into the throat so that swallowing can be viewed. Video of Barium swallow
Causes of Dysphagia in Inclusion Body Myositis
Cricopharyngeus muscle dysfunction is often responsible for swallowing difficulties. The cricopharngeus muscle, located in the upper throat, is also known as the upper esophageal sphincter. It relaxes during normal swallowing, opening up the esophagus so food can pass.

Cricopharyngeal achalasia - MediGoo - Health Tests and Medical Info Cricopharyngeal achalasia
Cricopharyngeal achalasia The condition is distinct from abnormalities of the normal relaxation response to the esophageal air distention and elevated resting tone. Diverse etiologies may cause the disorder, and a sequence of tests is usually necessary to confirm the diagnosis and exclude other conditions that might cause similar symptoms. Guidance on treatment options is limited due to the lack of controlled trials for the disorder as well as concern about accuracy of the diagnosis. Asherson was the first to consider the possibility that defective opening of the upper esophageal sphincter (UES) might cause swallowing problems. He describes in his study several patients with a characteristic profile radiograph of the pharynx: a hold-up of the barium bolus above the cricopharyngeus, swallowed boli which piled up in the hypopharynx forming a reservoir which acts as a «drip feed» to the esophagus. Asherson introduced the term "Cricopharyngeal achalasia" to describe this functional disturbance. He suggested that there was partial or complete failure, as well as a delay in the relaxation of the cricopharyngeal sphincter in these patients. However, Asherson gave no clear radiological description of the cricopharyngeus muscle itself. Unfortunately, the literature on cricopharyngeal achalasia has been made confusing by the lack of uniform definition of the condition.

The condition is distinct from abnormalities of the normal relaxation response to the esophageal air distention and elevated resting tone. Diverse etiologies may cause the disorder, and a sequence of tests is usually necessary to confirm the diagnosis and exclude other conditions that might cause similar symptoms. Guidance on treatment options is limited due to the lack of controlled trials for the disorder as well as concern about accuracy of the diagnosis. Asherson was the first to consider the possibility that defective opening of the upper esophageal sphincter (UES) might cause swallowing problems. He describes in his study several patients with a characteristic profile radiograph of the pharynx: a hold-up of the barium bolus above the cricopharyngeus, swallowed boli which piled up in the hypopharynx forming a reservoir which acts as a «drip feed» to the esophagus. Asherson introduced the term "Cricopharyngeal achalasia" to describe this functional disturbance. He suggested that there was partial or complete failure, as well as a delay in the relaxation of the cricopharyngeal sphincter in these patients. However, Asherson gave no clear radiological description of the cricopharyngeus muscle itself. Unfortunately, the literature on cricopharyngeal achalasia has been made confusing by the lack of uniform definition of the condition.

Pill Stuck in Throat Causing Heartburn & Acid Reflux | MedCline Medications That Cause Acid Reflux Symptoms When Stuck in Throat
Medications That Cause Acid Reflux Symptoms When Stuck in Throat
What Happens When a Pill Gets Stuck in Your Throat?
Why do pills get stuck?
Which Pills Can Cause Acid Reflux Symptoms?
What to do if medication causes acid reflux symptoms
How to Avoid Getting a Pill Stuck in Your Throat
What should I do if a pill gets stuck in my throat?
Other Tips for Managing Acid Reflux
MedCline Acid Reflux Relief Systems
 Pill esophagitis. Rom J Gastroenterol. 2005;14 (2):159-163. Medscape. Drug-induced Gastrointestinal Disorders. Jun 27, 2002. Mayo Clinic. Esophagitis. Sept 15, 2011. “Cricopharyngeal Dysfunction,” Columbia University Department of Otolaryngology Head and Neck Surgery, https://www.entcolumbia.org/health-library/cricopharyngeal-dysfunction#:~:text=This%20upper%20esophageal%20sphincter%20 (UES,and%20tight%20at%20most%20times.,

Pill Stuck in Throat Causing Heartburn & Acid Reflux | MedCline

Medications That Cause Acid Reflux Symptoms When Stuck in Throat
Medications That Cause Acid Reflux Symptoms When Stuck in Throat
What Happens When a Pill Gets Stuck in Your Throat?
Why do pills get stuck?
Which Pills Can Cause Acid Reflux Symptoms?
What to do if medication causes acid reflux symptoms
How to Avoid Getting a Pill Stuck in Your Throat
What should I do if a pill gets stuck in my throat?
Other Tips for Managing Acid Reflux
MedCline Acid Reflux Relief Systems

Pill esophagitis. Rom J Gastroenterol. 2005;14 (2):159-163. Medscape. Drug-induced Gastrointestinal Disorders. Jun 27, 2002. Mayo Clinic. Esophagitis. Sept 15, 2011. “Cricopharyngeal Dysfunction,” Columbia University Department of Otolaryngology Head and Neck Surgery, https://www.entcolumbia.org/health-library/cricopharyngeal-dysfunction#:~:text=This%20upper%20esophageal%20sphincter%20 (UES,and%20tight%20at%20most%20times.,

Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar - ScienceDirect Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar
Gastrointestinal Endoscopy
Case Study
Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar
Background
Methods
Observations
Conclusions
Patients and methods
Observations
Representative case
Discussion
References
 Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar - ScienceDirect
Gastrointestinal Endoscopy
Volume 61, Issue 1, January 2005, Pages 148-152
Case Study
Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar
Author links open overlay panel
Andrew Y.WangMD ReenaKadkadeMD Peter J.KahrilasMD Ikuo HiranoMD
https://doi.org/10.1016/S0016-5107 (04)02447-2 Get rights and content
Background
The cricopharyngeal (CP) bar is an uncommon but important cause of oropharyngeal dysphagia (OPD). Treatment options include CP myotomy, which can be problematic, because CP bars primarily occur in elderly patients who are at higher risk for perioperative complications. The effectiveness of esophageal dilation for patients with symptoms caused by a CP bar is not well studied. Methods
A review of medical records (1999 to 2002) identified 32 patients with CP bar. Six of these patients who had OPD that could only be attributed to a CP bar underwent EGD and dilation with either over-the-guidewire polyvinyl dilators (5) or a balloon (1). Observations
All 6 patients experienced immediate relief of dysphagia. Five had continued improvement at short-term follow-up (1 to 4 weeks). Three patients still had complete resolution of dysphagia at long-term follow-up (range 8 to 27 months). Conclusions
CP bar is an important cause of dysphagia in elderly patients. Esophageal dilation of a CP bar can produce long-term relief of dysphagia.

Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar - ScienceDirect

Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar
Gastrointestinal Endoscopy
Case Study
Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar
Background
Methods
Observations
Conclusions
Patients and methods
Observations
Representative case
Discussion
References

Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar - ScienceDirect
Gastrointestinal Endoscopy
Volume 61, Issue 1, January 2005, Pages 148-152
Case Study
Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar
Author links open overlay panel
Andrew Y.WangMD ReenaKadkadeMD Peter J.KahrilasMD Ikuo HiranoMD
https://doi.org/10.1016/S0016-5107 (04)02447-2 Get rights and content
Background
The cricopharyngeal (CP) bar is an uncommon but important cause of oropharyngeal dysphagia (OPD). Treatment options include CP myotomy, which can be problematic, because CP bars primarily occur in elderly patients who are at higher risk for perioperative complications. The effectiveness of esophageal dilation for patients with symptoms caused by a CP bar is not well studied. Methods
A review of medical records (1999 to 2002) identified 32 patients with CP bar. Six of these patients who had OPD that could only be attributed to a CP bar underwent EGD and dilation with either over-the-guidewire polyvinyl dilators (5) or a balloon (1). Observations
All 6 patients experienced immediate relief of dysphagia. Five had continued improvement at short-term follow-up (1 to 4 weeks). Three patients still had complete resolution of dysphagia at long-term follow-up (range 8 to 27 months). Conclusions
CP bar is an important cause of dysphagia in elderly patients. Esophageal dilation of a CP bar can produce long-term relief of dysphagia.

Management of chronic refractory cough | The BMJ Management of chronic refractory cough
Management of chronic refractory cough
Abstract
Introduction
Prevalence
Sources and selection criteria
Definition and terminology of chronic refractory cough
Cough hypersensitivity syndrome
Laryngeal hypersensitivity
Pathogenesis of chronic refractory cough
Cough reflex hypersensitivity
Peripheral sensitization
Central sensitization
Box 1: Evidence for central sensitization in chronic refractory cough
Paradoxical vocal fold movement
Clinical features of CRC
Diagnosis of chronic refractory cough
Primary assessment
Box 2: Red flags: alarm symptoms and findings in chronic cough 65
Box 3: Remediable conditions and conditions not to be missed in patients with chronic cough 65
Secondary assessment
Treatment of chronic refractory cough
Non-pharmacologic therapies
Box 4: Speech pathology treatment for chronic refractory cough 46
Pathophysiological assessment
Urge to cough
Voice assessment
Laryngeal assessment
Speech pathology treatment
Pharmacologic therapy
Neuromodulators
Morphine
Gabapentin
Amitriptyline
Baclofen
Combined pharmacologic and non-pharmacologic therapy
Inhaled corticosteroids
Other treatments
Outcome assessment after treatment
CRC in comorbid disease
Cancer
Chronic obstructive pulmonary disease
Cough in idiopathic pulmonary fibrosis
Emerging therapies for CRC
Guidelines
Conclusion
Questions for future research
Notes
Footnotes
References
 24 CRC is considered to be a phenotype of the cough hypersensitivity syndrome; although the precipitating factor is unknown, it has been hypothesized to be gastroesophageal reflux. 22
The concept of cough hypersensitivity syndrome has advantages. It may explain why only some people have associated conditions such as asthma, rhinosinusitis, and gastroesophageal reflux and others do not. It explains why cough is often refractory to treatment of associated conditions and why it may occur without an associated condition. It is also consistent with the observation that CRC often starts after an upper respiratory tract infection. The limitations are that much of the evidence to support cough hypersensitivity syndrome is based on expert opinion and that ways of objectively confirming cough hypersensitivity (such as cough reflex testing) are neither agreed nor recommended. In addition, it is not yet determined how the concept of cough hypersensitivity syndrome explains the origin of other symptoms, such as laryngeal symptoms and fatigue, which often coexist in patients with chronic cough. The European Respiratory Society task force examined the clinical relevance of the syndrome in a survey of 44 opinion leaders in 14 different countries. 14 Most respondents (89%) agreed that it was a useful concept, that it may mimic other pulmonary or extrapulmonary diseases (82%), and that it was distinct from bronchial hyper-responsiveness (82%).

Management of chronic refractory cough | The BMJ

Management of chronic refractory cough
Management of chronic refractory cough
Abstract
Introduction
Prevalence
Sources and selection criteria
Definition and terminology of chronic refractory cough
Cough hypersensitivity syndrome
Laryngeal hypersensitivity
Pathogenesis of chronic refractory cough
Cough reflex hypersensitivity
Peripheral sensitization
Central sensitization
Box 1: Evidence for central sensitization in chronic refractory cough
Paradoxical vocal fold movement
Clinical features of CRC
Diagnosis of chronic refractory cough
Primary assessment
Box 2: Red flags: alarm symptoms and findings in chronic cough 65
Box 3: Remediable conditions and conditions not to be missed in patients with chronic cough 65
Secondary assessment
Treatment of chronic refractory cough
Non-pharmacologic therapies
Box 4: Speech pathology treatment for chronic refractory cough 46
Pathophysiological assessment
Urge to cough
Voice assessment
Laryngeal assessment
Speech pathology treatment
Pharmacologic therapy
Neuromodulators
Morphine
Gabapentin
Amitriptyline
Baclofen
Combined pharmacologic and non-pharmacologic therapy
Inhaled corticosteroids
Other treatments
Outcome assessment after treatment
CRC in comorbid disease
Cancer
Chronic obstructive pulmonary disease
Cough in idiopathic pulmonary fibrosis
Emerging therapies for CRC
Guidelines
Conclusion
Questions for future research
Notes
Footnotes
References

24 CRC is considered to be a phenotype of the cough hypersensitivity syndrome; although the precipitating factor is unknown, it has been hypothesized to be gastroesophageal reflux. 22
The concept of cough hypersensitivity syndrome has advantages. It may explain why only some people have associated conditions such as asthma, rhinosinusitis, and gastroesophageal reflux and others do not. It explains why cough is often refractory to treatment of associated conditions and why it may occur without an associated condition. It is also consistent with the observation that CRC often starts after an upper respiratory tract infection. The limitations are that much of the evidence to support cough hypersensitivity syndrome is based on expert opinion and that ways of objectively confirming cough hypersensitivity (such as cough reflex testing) are neither agreed nor recommended. In addition, it is not yet determined how the concept of cough hypersensitivity syndrome explains the origin of other symptoms, such as laryngeal symptoms and fatigue, which often coexist in patients with chronic cough. The European Respiratory Society task force examined the clinical relevance of the syndrome in a survey of 44 opinion leaders in 14 different countries. 14 Most respondents (89%) agreed that it was a useful concept, that it may mimic other pulmonary or extrapulmonary diseases (82%), and that it was distinct from bronchial hyper-responsiveness (82%).