User:Mr. Ibrahem/Distal esophageal spasm
Medical condition / From Wikipedia, the free encyclopedia
Distal esophageal spasm (DES), also known as diffuse esophageal spasm, is a condition in which there is uncoordinated contractions of the esophagus.[1] Symptoms may include difficulty swallowing, regurgitation, felling like something is stuck in the throat, and chest pain.[1][3] Difficulty swallowing may occur with both solids and liquids.[1] Complications may rarely include achalasia.[3][2]
Mr. Ibrahem/Distal esophageal spasm | |
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Other names | Diffuse esophageal spasm |
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A barium swallow showing a corkscrew appearance due to distal esophageal spasm | |
Specialty | Gastroenterology |
Symptoms | Difficulty swallowing, regurgitation, chest pain[1] |
Complications | Achalasia[2] |
Usual onset | Around 60 yr old[2] |
Causes | Unknown[1] |
Risk factors | GERD, obesity, high cholesterol, high blood sugar[1] |
Diagnostic method | Esophageal manometry, barium swallow[1][3] |
Differential diagnosis | Angina, esophageal cancer, esophageal stricture, esophagitis, achalasia, esophageal web[1] |
Treatment | Peppermint oil, nitrates, calcium channel blockers, esophageal dilation, botulinum toxin injects[2][1] |
Frequency | 1 per 100,000 people per year[1] |
The cause is unknown.[1] Episodes may be triggered by eating quickly or foods at extremes of temperature.[1] Risk factors include GERD, obesity, high cholesterol, and high blood sugar.[1] While the esophageal contractions are uncoordinated they are of normal strength and the lower esophagus opens normally.[1] Diagnosis may be supported by esophageal manometry, with testing such as endoscopy and barium swallow done to rule out other causes.[1] It is a type of esophageal motility disorder.[2]
Treatment options include peppermint oil, nitrates, calcium channel blockers, esophageal dilation, and botulinum toxin injects.[2][1] Proton-pump inhibitors may be used to treat associated GERD.[1] Rarely surgery may be carried out.[1] Outcomes are variable.[1]
Diffuse esophageal spasm affects about 1 per 100,000 people per year.[1] It represents less than 10% of no heart related chest pain.[1] It is most common in those around the age of 60 and women are affected more often than men.[2][1] The condition was first described in 1889 by Osgood.[2]