From the Research
Esophageal contractions can be classified into primary, secondary, and tertiary types, with primary contractions being the normal, coordinated peristaltic waves that occur when swallowing, secondary contractions being involuntary peristaltic waves that occur in response to esophageal distension, and tertiary contractions being non-peristaltic, uncoordinated, and often simultaneous contractions that don't effectively move food downward. The most recent and highest quality study on this topic is from 2021 1, which discusses hypercontractile esophagus, a condition characterized by abnormal esophageal contractions. According to this study, hypercontractile esophagus is diagnosed when ≥20% hypercontractile peristaltic sequences are present within the context of normal lower esophageal sphincter relaxation on esophageal high-resolution manometry. Some key points about esophageal contractions include:
- Primary contractions are initiated voluntarily and continue as an involuntary reflex, propelling food from the pharynx to the stomach.
- Secondary contractions occur in response to esophageal distension, such as when food becomes stuck, and help clear the esophagus.
- Tertiary contractions are abnormal and don't effectively move food downward, and are associated with motility disorders like achalasia, diffuse esophageal spasm, and nutcracker esophagus. Other studies, such as those from 2006 2, 2014 3, 2016 4, and 1991 5, provide additional information on esophageal contractions, but the 2021 study 1 is the most recent and highest quality. Understanding these contraction types is essential for diagnosing and treating esophageal motility disorders, which are typically evaluated using manometry to measure pressure patterns and coordination of esophageal muscle activity.