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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