Abstract
Achalasia cardia (“cardiospasm”, “phrenospasm”, “dolichoesophagus”, “megaesophagus”, “stenosis of cardia”) represents a primary impairment of esophageal motor function associated with impaired lower esophageal sphincter relaxation and peristalsis defects of the thoracic esophagus. It is diagnosed at the age of 25 to 60 years, making up to 20% of all diseases of the esophagus, and is characterized by a triad of symptoms: dysphagia, regurgitation and chest pain when swallowing. In most cases the first manifestations of achalasia are preceded by stress situations in the anamnesis that complicates the differential diagnosis of psychogenic esophageal spasm. The presented clinical case illustrates difficulties of early diagnosis of achalasia cardia in a young femalepatient with severe anxiety and depressive symptoms which develop under conditions of chronic stressful situations in the family or at work. The issues of interdisciplinary interaction of health professionals (physician, gastroenterologist, psychiatrist, psychotherapist, and surgeon) on the course of examination and management of patients with comorbid physical and mental pathology are discussed. The efficiency of the integrative approach to treatment and rehabilitation with the use of modern reconstructive surgical interventions as well as conservative methods of therapy, psychopharmacotherapy and personality-oriented psychotherapy proves the relevance of studying psychosomatic aspects of achalasia cardia.
Highlights
Achalasia cardia (“cardiospasm”, “phrenospasm”, “dolichoesophagus”, “megaesophagus”, “stenosis of cardia”) represents a primary impairment of esophageal motor function associated with impaired lower esophageal sphincter relaxation and peristalsis defects of the thoracic esophagus
It is diagnosed at the age of 25 to 60 years, making up to 20% of all diseases of the esophagus, and is characterized by a triad of symptoms: dysphagia, regurgitation and chest pain when swallowing
In most cases the first manifestations of achalasia are preceded by stress situations in the anamnesis that complicates the differential diagnosis of psychogenic esophageal spasm
Summary
Коморбидность ахалазии пищевода, смешанной тревожной и депрессивной реакции у пациентки молодого возраста: проблемы диагностики и лечения. Гарганеева Н.П.1, 2, Белокрылова М.Ф.1, 2, Костин А.К.2, Кошель А.П.1, Епанчинцева Е.М.2, Лебедева В.Ф.2, Аксенов М.М.2, Перчаткина О.Э.2, Карташова И.Г.2, Рудницкий В.А.1, 2, Горбацевич Ю.Н.2, Цыбульская Е.В.2, Алексеев В.А.1. Представленный клинический случай иллюстрирует трудности диагностики ахалазии кардиального отдела пищевода у женщины молодого возраста с выраженной тревожной и депрессивной симптоматикой, развившейся в условиях хронической стрессовой ситуации семейного и производственного плана. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи. Авторы заявляют об отсутствии финансирования при проведении исследования. Для цитирования: Гарганеева Н.П., Белокрылова М.Ф., Костин А.К., Кошель А.П., Епанчинцева Е.М., Лебедева В.Ф., Аксенов М.М., Перчаткина О.Э., Карташова И.Г., Рудницкий В.А., Горбацевич Ю.Н., Цыбульская Е.В., Алексеев В.А. Коморбидность ахалазии пищевода, смешанной тревожной и де-. Случай из клинической практики прессивной реакции у пациентки молодого возраста: проблемы диагностики и лечения. Garganeeva N.P.1, 2, Belokrylova M.F.1, 2, Kostin A.K.2, Koshel A.P.1, Epanchintseva E.M.2, Lebedeva V.F.2, Aksenov M.M.2, Perchatkina O.E.2, Kartashova I.G.2, Rudnitsky V.A.1, 2, Gorbatsevich Yu.N.2, Tsybulskaya E.V.2, Alekseev V.A.1
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