Presbyoesophagus

Last revised by Yuranga Weerakkody on 3 Feb 2023

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 older 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:

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