Presbyoesophagus is term that has been traditionally used to describe the manifestations of degenerating motor function in the aging esophagus.
Presbyoesophagus remains controversial given it was initially described in elderly patients with significant co-morbidities (e.g. dementia, diabetes), and subsequent studies have described less severe changes and only minor differences in esophageal function in healthy patients less than 80 years old.
Presbyoesophagus is typically seen in patients more than 80 years old.
Patients may complain of dysphagia or chest pain, although most are asymptomatic.
Various mechanisms have been proposed:
- interruption of the reflex arc, perhaps from a central cause (e.g. ischemic stroke)
- decreased sensitivity to distension and reduced secondary peristalsis
On barium swallow the following features may be seen 6,7:
- decreased frequency of normal peristalsis
- tertiary contractions (ranging from minor to severe)
- esophageal dilatation
- impaired lower esophageal sphincter relaxation
Other motility disorders should be considered:
- 1. Hannig C, Wuttge-Hannig A, Rummeny E. Esophageal motility disorders. Radiologe. 2007;47 (2): 123-36. doi:10.1007/s00117-007-1472-1 - Pubmed citation
- 2. DeVault KR. Presbyesophagus: a reappraisal. Curr Gastroenterol Rep. 2002;4 (3): 193-9. Pubmed citation
- 3. Ren J, Shaker R, Kusano M et-al. Effect of aging on the secondary esophageal peristalsis: presbyesophagus revisited. Am. J. Physiol. 1995;268 (5 Pt 1): G772-9. Pubmed citation
- 4. ZBORALSKE FF, AMBERG JR, SOERGEL KH. PRESBYESOPHAGUS: CINERADIOGRAPHIC MANIFESTATIONS. Radiology. 1996;82: 463-7. Pubmed citation
- 5. Besanko LK, Burgstad CM, Mountifield R et-al. Lower esophageal sphincter relaxation is impaired in older patients with dysphagia. World J. Gastroenterol. 2011;17 (10): 1326-31. doi:10.3748/wjg.v17.i10.1326 - Free text at pubmed - Pubmed citation
- 6. Eisenberg RL. Gastrointestinal radiology. Lippincott Williams & Wilkins. (2003) ISBN:0781737060. Read it at Google Books - Find it at Amazon
- 7. Gore RM, Levine MS. Textbook of Gastrointestinal Radiology. Saunders. (2008) ISBN:1416023321. Read it at Google Books - Find it at Amazon
- 8. Richter J. The Lancet. 2001;358 (9284): . doi:10.1016/S0140-6736(01)05973-6
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