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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 characterized by high-amplitude peristaltic contractions that are frequently prolonged and cause dysphagia and chest pain. [ 6 ] HLES (hypertensive lower esophageal sphincter) is a rare manometric abnormality seen among individuals with dysphagia, chest pain, gastroesophageal reflux , and hiatal hernia .
Esophageal rings or strictures may be treated with esophageal dilation. Simple observation may be considered, [5] especially if symptoms are minimal or absent. If symptoms are severe or persistent, peroral endoscopic myotomy (POEM) may be offered. [2]
Esophageal cancer also presents with progressive mechanical dysphagia. Patients usually come with rapidly progressive dysphagia first with solids then with liquids, weight loss (> 10 kg), and anorexia (loss of appetite). Esophageal cancer usually affects the elderly. Esophageal cancers can be either squamous cell carcinoma or adenocarcinoma.
It can be caused by or associated with gastroesophageal reflux disease, [1] esophagitis, a dysfunctional lower esophageal sphincter, disordered motility, lye ingestion, or a hiatal hernia. Strictures can form after esophageal surgery and other treatments such as laser therapy or photodynamic therapy. While the area heals, a scar forms, causing ...
Some people also experience a sensation known as globus esophagus, where it feels as if a ball is lodged in the lower part of the esophagus. The following are additional diseases and conditions that affect the esophagus: Achalasia [1] Acute esophageal necrosis; Barrett's esophagus; Boerhaave syndrome; Caustic injury to the esophagus; Chagas disease
Esophageal achalasia is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter (LES). [5] It is characterized by incomplete LES relaxation, increased LES tone, and lack of peristalsis of the esophagus (inability of smooth muscle to move food down the esophagus) in the absence of ...