ACR Codes: 7.9
Presbyesophagus, defined as abnormal esophageal motor function related to aging, is usually asymptomatic. The disorder is due to a decrease in ganglion cells in Auerbachâ€™s plexus, with resultant decrease in normal peristalsis, increase in tertiary contractions, and LES dysfunction. Findings on contrast examination reveal failure of the primary peristaltic wave to reach the distal esophagus and non-propulsive tertiary contractions. Mild to moderate esophageal dilatation may occur from incomplete relaxation of the LES.
The disorder has come into question due to the fact that many patients formerly diagnosed with presbyesophagus had concomitant neurologic disorders or diabetes mellitus, either of which can cause the aforementioned symptoms. The term nonspecific esophageal motility disorder (NEMD) has been proposed to describe patients whose symptoms are not easily classified.
Most healthy elderly individuals, however, will show some changes of esophageal function. It is theorized that these changes may be due to long-standing GERD, worsened by a decreasing ability of elderly patients to sense pathologic changes in their esophagus. Patients with more severe mucosal disease would thus present with fewer symptoms. Age-associated changes in the upper esophageal sphincter and pharynx have also been observed.
Reference(s): Cummings, Otolaryngology: Head and Neck Surgery, 3rd ed, 1998, 2321.
DeVault KR, Current Gastroenterology Reports, 1 JUNE 2002: 4(3), 193-9.