Abstract：
BACKGROUND: Hypercontractile esophagus is a rare hypercontractile esophageal motility disorder. The etiology of hypercontractile esophagus is unknown but an association between acid reflux and hypercontractile esophagus has been suggested. We present the first report on the use of potassium-competitive acid blockers in the treatment of hypercontractile esophagus.
METHODS: A 43-year-old man presented with dysphagia, chest pain and regurgitation for a period of 1 year. Initial workup showed a twisted lumen with abnormal contractions in the distal esophagus during upper gastrointestinal endoscopy and abnormal acid exposure under 24-h esophageal pH monitoring. The use of standard-dose proton pump inhibitors didn\'t relieve his symptoms. Subsequent high-resolution esophageal manometry made a diagnosis of hypercontractile esophagus. Treatment with vonoprazan resulted in symptomatic resolution and abnormal contractions were no longer detected on follow-up high-resolution manometry.
CONCLUSIONS: Potassium-competitive acid blockers like vonoprazan offer an alternative therapeutic method for patients with hypercontractile esophagus who are refractory to proton pump inhibitor therapy. The use of potassium-competitive acid blockers in hypercontractile esophagus warrants further research and may provide evidence for an acid-related etiology of hypercontractile esophagus.
METHODS: A 43-year-old man presented with dysphagia, chest pain and regurgitation for a period of 1 year. Initial workup showed a twisted lumen with abnormal contractions in the distal esophagus during upper gastrointestinal endoscopy and abnormal acid exposure under 24-h esophageal pH monitoring. The use of standard-dose proton pump inhibitors didn\'t relieve his symptoms. Subsequent high-resolution esophageal manometry made a diagnosis of hypercontractile esophagus. Treatment with vonoprazan resulted in symptomatic resolution and abnormal contractions were no longer detected on follow-up high-resolution manometry.
CONCLUSIONS: Potassium-competitive acid blockers like vonoprazan offer an alternative therapeutic method for patients with hypercontractile esophagus who are refractory to proton pump inhibitor therapy. The use of potassium-competitive acid blockers in hypercontractile esophagus warrants further research and may provide evidence for an acid-related etiology of hypercontractile esophagus.
摘要：
背景：食管过度收缩是一种罕见的食管过度收缩运动障碍。食管过度收缩的病因尚不清楚，但已提出酸反流与食管过度收缩之间的关联。我们介绍了使用钾竞争性酸阻滞剂治疗食管过度收缩的第一份报告。
方法：一名43岁男子出现吞咽困难，胸痛和反流持续1年。最初的检查显示，上消化道内窥镜检查期间远端食道的管腔扭曲，在24小时食道pH监测下异常酸暴露。使用标准剂量质子泵抑制剂并不能缓解他的症状。随后的高分辨率食管测压诊断为食管过度收缩。vonoprazan治疗可导致症状缓解，并且在后续高分辨率测压法中不再检测到异常收缩。
结论：钾竞争性酸阻滞剂，如沃诺拉赞，为质子泵抑制剂治疗难以治疗的食管过度收缩患者提供了一种替代治疗方法。在过度收缩食管中使用钾竞争性酸阻滞剂值得进一步研究，并可能为与酸相关的食管过度收缩病因提供证据。
方法：一名43岁男子出现吞咽困难，胸痛和反流持续1年。最初的检查显示，上消化道内窥镜检查期间远端食道的管腔扭曲，在24小时食道pH监测下异常酸暴露。使用标准剂量质子泵抑制剂并不能缓解他的症状。随后的高分辨率食管测压诊断为食管过度收缩。vonoprazan治疗可导致症状缓解，并且在后续高分辨率测压法中不再检测到异常收缩。
结论：钾竞争性酸阻滞剂，如沃诺拉赞，为质子泵抑制剂治疗难以治疗的食管过度收缩患者提供了一种替代治疗方法。在过度收缩食管中使用钾竞争性酸阻滞剂值得进一步研究，并可能为与酸相关的食管过度收缩病因提供证据。
