Diffuse esophageal spasm. A rare motility disorder not characterized by high-amplitude contractions

Dig Dis Sci. 1991 Aug;36(8):1025-8. doi: 10.1007/BF01297441.


Diffuse esophageal spasm (DES) has frequently been described as a motility disorder characterized by simultaneous, high-amplitude contractions. We reviewed the results of esophageal manometry testing on a total of 1480 patients referred to our lab over 36 months. Lower esophageal sphincter (LES) pressure was determined by a mean of four station pull-through. Esophageal body motility was assessed following 10 wet swallows. In our lab a diagnosis of DES is made when greater than 10% but less than 100% of contractions are simultaneous. Manometric findings of DES were rare, with an overall prevalence of 4% (56/1480). Of the 56 patients with a manometric diagnosis of DES, high-amplitude (mean greater than or equal to 180 mm Hg) peristaltic contractions were found in only two (4%). No simultaneous contractions with amplitude greater than or equal to 180 mm Hg were seen. Pressures of simultaneous contractions were consistently lower than peristaltic contractions. A hypertensive LES pressure (greater than or equal to 45 mm Hg) was present in 5/56 DES patients (9%). Poor LES relaxation was found in 7/56 DES patients (13%). We conclude that DES is a rare manometric finding, regardless of the reason for referral, and that the occurrence of high-amplitude contractions in DES is equally rare.

MeSH terms

  • Esophageal Spasm, Diffuse / diagnosis
  • Esophageal Spasm, Diffuse / epidemiology*
  • Esophageal Spasm, Diffuse / physiopathology
  • Esophagogastric Junction / physiopathology
  • Esophagus / physiopathology*
  • Female
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Peristalsis / physiology
  • Pressure
  • Prevalence