Fact-sheet: Diffuse esophageal spasm
Updated on 09/17/2021 at 12:16 PM
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Definition
Diffuse esophageal spasm = segmental spasm disease.
Primary motor disorder.
Neurologic disease with predominant inhibitory denervation.
5 times less common than achalasia
Clinical features
Chest pain.
Intermittent, erratic dysphagia, less pronounced than in achalasia, worsened by stress
Radiography
Segmental, multilevel spasms with a corkscrew or pseudo-diverticular appearance.
Management
Esophageal manometry: simultaneous, high-amplitude, prolonged contractions, with intermittent preservation of peristalsis and frequent repetitive contractions.
Lower esophageal sphincter normal in 2/3 of patients; hypertonic or with incomplete relaxation in 1/3
Differential diagnosis
IMPORTANT.
Diagnosis of exclusion.
Neurologic disease.
Distal tumoral or benign obstruction.
Other nonspecific motor disorders: achalasia