Published online Dec 16, 2017. doi: 10.4253/wjge.v9.i12.590
Peer-review started: August 27, 2017
First decision: October 9, 2017
Revised: October 25, 2017
Accepted: November 11, 2017
Article in press: November 11, 2017
Published online: December 16, 2017
Processing time: 102 Days and 4.5 Hours
Jackhammer (hypercontractile) esophagus presents with dysphagia and chest pain. Current treatments are limited. We describe a 60-year-old man who presented with dysphagia, chest pain and heartburn for a period of 1 year. His workup showed Barrett’s esophagus on endoscopy and high-resolution manometry demonstrated jackhammer esophagus with esophagogastric junction outflow obstruction. The patient was treated with proton pump inhibitor and nifedipine but without resolution of his symptoms. He was followed up to assess the efficacy of treatment with deanxit (flupentixol + melitracen). Dysphagia and chest pain resolved during the therapeutic trial and efficacy was maintained on maintenance treatment without troublesome side effects.
Core tip: Low-dose antidepressants can improve patients’ reaction to the pain associated with esophageal dynamic disorders. The case report describes that deanxit (flupentixol + melitracen) has a positive effect on a new, rare disease, jackhammer esophagus, and speculates upon the potential relationship between mental factors and jackhammer esophagus.