Deanxit relieves symptoms in a patient with jackhammer esophagus: A case report

Figure 1 The workup of the patient for the first time. A: Esophageal lesions of the patient under endoscopy, which were suggestive of BE; B: Barium esophagogram showing reflux esophagitis and spastic contraction in the distal esophagus; C: Representative swallow from the patient’s initial HRM. The median IRP was high at 21.5 mmHg, and the DCI was elevated to 8099.9 mmHg-s-cm; D: 24-h pH-impedance monitoring. It can monitor 100% acid reflux into the esophagus. DCI: Distal contractile integral; HRM: High-resolution manometry; IRP: Integrated relaxation pressure.

Figure 2 Esophageal test results for the second time. A: Representative swallow from the patient’s repeat esophageal HRM. Median IRP was normal at 14.7 mmHg. DCI was higher than normal, which was 8120.1 mmHg-cm-s, and six swallows with DCI > 8000 mmHg-s-cm in 10 liquid swallows. Esophageal manometry was consistent with jackhammer esophagus; B: 24-h pH-impedance monitoring was repeated, which was negative for gastroesophageal reflux disease. DCI: Distal contractile integral; HRM: High-resolution manometry; IRP: Integrated relaxation pressure.

Figure 3 A representative swallow from the patient’s repeat esophageal high-resolution manometry after administration of deanxit. Median IRP was elevated at 10.1 mmHg. DCI of each swallow was higher than the normal range but < 8000 mmHg-cm-s, which was improved after treatment. DCI: Distal contractile integral; IRP: Integrated relaxation pressure.