Distal Esophageal Spasm: A Review

Am J Med. 2018 Sep;131(9):1034-1040. doi: 10.1016/j.amjmed.2018.02.031. Epub 2018 Mar 29.

Abstract

Distal esophageal spasm is a rare motility disorder presenting principally with nonobstructive dysphagia and noncardiac chest pain. In symptomatic patients, the manometric diagnosis is made when >10% of the wet swallows have simultaneous and/or premature contractions intermixed with normal peristalsis. We characterize manometry and barium as complementary diagnostic approaches, and given the intermittent nature of the disorder, one should be always aware that it is almost impossible to rule out spasm. Treatment is difficult; we propose an approach beginning with the least invasive intervention.

Keywords: Chest pain; Dysphagia; Esophagus; Motility.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents, Tricyclic / therapeutic use
  • Barium Radioisotopes
  • Botulinum Toxins / therapeutic use
  • Calcium Channel Blockers / therapeutic use
  • Esophageal Achalasia / complications
  • Esophageal Spasm, Diffuse / complications*
  • Esophageal Spasm, Diffuse / diagnosis
  • Esophageal Spasm, Diffuse / therapy*
  • Gastroesophageal Reflux / complications
  • Humans
  • Isosorbide Dinitrate / therapeutic use
  • Manometry
  • Mentha piperita
  • Myotomy
  • Nitric Oxide Donors / therapeutic use
  • Phosphodiesterase 5 Inhibitors / therapeutic use
  • Plant Oils / therapeutic use
  • Prevalence
  • Proton Pump Inhibitors / therapeutic use
  • Terminology as Topic

Substances

  • Antidepressive Agents, Tricyclic
  • Barium Radioisotopes
  • Calcium Channel Blockers
  • Nitric Oxide Donors
  • Phosphodiesterase 5 Inhibitors
  • Plant Oils
  • Proton Pump Inhibitors
  • peppermint oil
  • Botulinum Toxins
  • Isosorbide Dinitrate