Esophageal spasm

Esophageal spasm 

Updated: 02/12/2021

© Jun Wang, MD, PhD

General features
  • More common in white, women
  • Symptoms may improve over time
  • Nutcracker esophagus/hypertensive peristalsis
High-amplitude
Coordinated contractions of the distal esophagus
  • Diffuse esophageal spasm
Normal amplitude
Uncoordinated, simultaneous, or rapidly propagated, contractions of the distal esophageal smooth muscle
Clinical presentations
  • Dysphagia, regurgitation, and noncardiac chest pain
Diagnosis
  • Best diagnostic modality: High-resolution manometry
Treatment
  • Calcium channel blockers, botulinum toxin, nitrates, tricyclic antidepressants, sildenafil, dilatation
  • Myotomy, and esophagectomy



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