Presbyoesophagus is term that has been traditionally used to describe the manifestations of degenerating motor function in the ageing oesophagus.
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 oesophageal function in healthy patients less than 80 years old.
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Epidemiology
Presbyoesophagus is typically seen in patients older than 80 years old.
Clinical presentation
Patients may complain of dysphagia or chest pain, although most are asymptomatic.
Pathology
Various mechanisms have been proposed:
interruption of the reflex arc, perhaps from a central cause (e.g. ischaemic stroke)
decreased sensitivity to distension and reduced secondary peristalsis
Radiographic features
Fluoroscopy
On barium swallow the following features may be seen 6,7:
decreased frequency of normal peristalsis
tertiary contractions (ranging from minor to severe)
oesophageal dilatation
impaired lower oesophageal sphincter relaxation
Differential diagnosis
Other motility disorders should be considered: