Esophageal Motility disorders are not uncommon in gastroenterology. The spectrum of these disorders ranges from the well-defined primary esophageal motility disorders (PEMDs) to very nonspecific disorders that may play a more indirect role in reflux disease and otherwise be asymptomatic. Esophageal motility disorders may occur as manifestations of systemic diseases, referred to as secondary motility disorders.

Esophageal motility disorders are less common than mechanical and inflammatory diseases affecting the esophagus, such as reflux esophagitis, peptic strictures, and mucosal rings. The clinical presentation of a motility disorder is varied, but, classically, dysphagia and chest pain are reported. In 80% of patients, the cause of a patient's dysphagia can be suggested from the history, including dysmotility of the esophagus. Before entertaining a diagnosis of a motility disorder, first and foremost, the physician must evaluate for a mechanical obstructing lesion.

For more information, please see www.emedicine.com/med/TOPIC740.HTM eMedicine – http://emedicine.medscape.com/article/174783-overview

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Enthesopathies In medicine, an enthesopathy refers to a disorder of entheses (bone attachments).  If the condition is known to be inflammatory, it can more precisely be called a enthesitis. Enthesopathies are disorders of peripheral ligamentous or muscular attachments.
Examples include spondoarthropathy such as ankylosing spondylitis, plantar fascitis, and Achilles tendinitis

  • Adhesive capsulitis of shoulder
  • Rotator cuff syndrome of shoulder and allied disorders
  • Periarthritis of shoulder
  • Scapulohumeral fibrositis
  • Enthesopathy of elbow region
  • Enthesopathy of wrist and carpus
  • Bursitis of hand or wrist
  • Periarthritis of wrist
  • Enthesopathy of hip region
  • Bursitis of hip
  • Gluteal tendinitis
  • Iliac crest spur
  • Psoas tendinitis
  • Trochanteric tendinitis
  • Enthesopathy of knee
  • Enthesopathy of ankle, tarsus and calcaneous
  • Other peripheral enthesopathies
  • Unspecified enthesopathy

For more information, please see



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Dysmenorrhea refers to the syndrome of painful menstruation. Primary dysmenorrhea occurs in the absence of pelvic pathology, whereas secondary dysmenorrhea results from identifiable organic diseases, most typically endometriosis, uterine fibroids, uterine adenomyosis, or chronic pelvic inflammatory disease. The prevalence of dysmenorrhea is estimated to be between 45 and 95% among reproductive-aged women. Although not life threatening, dysmenorrhea can be debilitating and psychologically taxing for many women and is one of the leading causes of absenteeism from work and school.

American Congress of Obstetricians and Gynecologists – http://www.acog.org/publications/patient_education/bp046.cfm

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A condition in which tissue lining the uterus (endometrium) begins to grow in other regions of the body.  This growth causes pain, irregular bleeding, and possible infertility.  This tissue growth usually occurs in the pelvic area, outside the uterus, on the ovaries, bowel, rectum, bladder, and the lining of the pelvis.  Though, these growths can also occur in other areas of the body.

This continual process can eventually cause scars (adhesions) on the tubes, ovaries, and surrounding structures in the pelvis.  Buildup of scars causes high pain.

Sometimes running in the family, the condition is typically diagnosed between the ages of 25-35; probably around the time menstruation begins.  Women with a mother or sister previously diagnosed with endometriosis are six times more likely to develop the disease.

The Endometriosis Association - http://www.endometriosisassn.org/

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Depression in fibromyalgia is a controversial topic. In support of the contention that fibromyalgia is not a psychiatric illness, some authors believe that no correlation exists between fibromyalgia symptoms and psychological factors; others have determined that fibromyalgia is not a psychiatric disorder. The depression associated with fibromyalgia is believed to result from the pain, sleep deprivation, and dysfunction.

Depression in fibromyalgia may be treated with a regimen that includes nonpharmaceuticals. Antidepressants may help, but the clinician also should address other symptoms, such as fatigue or pain. Modifying diet and practicing good sleep hygiene are crucial. Starting a rehabilitation exercise program also is important. Some authors suggest that behavioral modification techniques and stress management also should be employed.

For further information, please see http://fmscommunity.org/fibro.htm The National Institute of Mental Health (NIMH) – http://www.nimh.nih.gov/health/topics/depression/index.shtml

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