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Diffuse esophageal spasm (DES), also known as distal esophageal spasm, is a condition characterized by uncoordinated contractions of the esophagus, which may cause difficulty swallowing or regurgitation. In some cases, it may cause symptoms such as chest pain, similar to heart disease. In many cases, the cause of DES remains unknown.
Esophageal spasm is a disorder of motility of the esophagus. [2] There are two types of esophageal spasm: [2] Diffuse or distal esophageal spasm (DES), where there is uncoordinated esophageal contractions; Nutcracker esophagus (NE) also known as hypertensive peristalsis, where the contractions are coordinated but with an excessive amplitude.
Nutcracker esophagus is one of several motility disorders of the esophagus, including achalasia and diffuse esophageal spasm. It causes difficulty swallowing with both solid and liquid foods, and can cause significant chest pain; it may also be asymptomatic. Nutcracker esophagus can affect people of any age but is more common in the sixth and ...
Diffuse esophageal spasm (DES) is a motility disorder characterized by recurrent episodes of chest pain or dysphagia as well as nonpropulsive (tertiary) contractions on radiographs. [5] Nutcracker esophagus is characterized by high-amplitude peristaltic contractions that are frequently prolonged and cause dysphagia and chest pain. [6]
Hyoscine butylbromide, also known as scopolamine butylbromide [4] and sold under the brandname Buscopan among others, [5] is an anticholinergic medication used to treat abdominal pain, esophageal spasms, bladder spasms, biliary colic, [6] and renal colic. [7] [8] It is also used to improve excessive respiratory secretions at the end of life. [9]
Antispasmodic medicines (immediate benefit) Nifedipine, in small doses (2x 5 mg per day, 10 mg per day in slow release or as much as the blood pressure allows it), can be prescribed in an attempt to provide a first relief, by blocking the esophageal spasms that may be involved and reduce the reflux going up to the throat.
The role of the members of the multidisciplinary team will differ depending on the type of swallowing disorder present. For example, the swallowing therapist will be directly involved in the treatment of a patient with oropharyngeal dysphagia, while a gastroenterologist will be directly involved in the treatment of an esophageal disorder.
Isosorbide dinitrate is a medication used for heart failure, esophageal spasms, and to treat and prevent chest pain from not enough blood flow to the heart. [1] It has been found to be particularly useful in heart failure due to systolic dysfunction together with hydralazine. [2] [1] It is taken by mouth or under the tongue. [1]