Materiały źródłowe

• #1 Esophageal spasms – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/symptoms-causes/syc-20372250

  Esophageal spasms usually happen only now and then, and they might not need treatment. But sometimes the spasms happen a lot and can prevent food and liquids from traveling through the esophagus. If esophageal spasms affect the ability to eat or drink, treatments are available. […] The squeezing chest pain that happens with esophageal spasms also can be caused by a heart attack. If you have squeezing chest pain, seek medical care right away. […] It’s not clear what causes esophageal spasms. However, they appear to be related to abnormal functioning of nerves that control the muscles used when swallowing. […] Esophageal spasms make it difficult for the muscles in the walls of the lower esophagus to coordinate. This makes it harder for the muscles to move food to the stomach. […] There are two types of esophageal spasms distal esophageal spasm and hypercontractile esophagus, also known as nutcracker esophagus. […] Risk factors for esophageal spasms include: Women are more likely to have esophageal spasms than men. Esophageal spasms tend to happen around age 60.

• #2 Esophageal Spasm: Causes, Symptoms, Treatments, & Diagnosis

  https://www.webmd.com/digestive-disorders/what-is-esophageal-spasm

  Esophageal Spasm Diagnosis […] Because spasms cause symptoms similar to a heart attack, your doctor will first run tests to check your heart health. Its important to rule out angina, a type of chest pain caused by coronary artery disease. […] Your doctor also will check for signs of gastroesophageal reflux disease (GERD), which can cause heartburn and make it hard to swallow. You can have both GERD and esophageal spasms. […] Tests your doctor may order include: […] Manometry. This is the only test that can confirm esophageal spasms. During this procedure, the doctor inserts a thin tube into your esophagus. Sensors on the tube measure pressure in the esophagus and reveal how well the muscles relax when you swallow. […] If you have repeated episodes of chest pain but your doctor has ruled out heart problems and GERD, talk to them about this condition. Esophageal spasms that come and go sometimes take years to diagnose.

• #3 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Your healthcare provider will perform a physical exam to evaluate your symptoms. If you have chest pain, your provider may order tests, such as an electrocardiogram (EKG), to rule out heart disease. […] Once theyve ruled out heart disease, theyll likely perform tests to rule out more common conditions that may be causing your symptoms. These include: […] Tests used to diagnose esophageal spasms specifically include: […] Esophageal manometry: This test measures pressure waves inside your esophagus when you swallow. Its the gold-standard (most used and reliable) test to diagnose esophageal spasms. An unusually large number of simultaneous contractions in your lower esophagus is a major indicator of spasms. […] Esophageal spasms can be tricky to diagnose since several conditions cause the telltale symptoms: chest pain and trouble swallowing. […] Once your provider determines your issue isnt heart-related, theyll rule out more common digestive system conditions with similar symptoms.

• #4 Evaluation of the adult with chest pain of esophageal origin – UpToDate

  https://www.uptodate.com/contents/evaluation-of-the-adult-with-chest-pain-of-esophageal-origin

  GERD is the most likely cause for recurring unexplained chest pain of esophageal origin. […] Approximately 50 percent of patients with recurrent noncardiac chest pain have abnormal esophageal acid exposure. […] While an empiric diagnosis of „esophageal spasm” was previously applied to patients with unexplained noncardiac chest pain of esophageal origin, underlying esophageal motility disorders (eg, achalasia, distal esophageal spasm, jackhammer esophagus) are uncommon.

• #5 Esophageal Spasm | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/esophageal-spasm-ut1638spec

  Esophageal spasm is not common. […] The diagnosis can be confirmed with tests, including esophagus tests (such as esophageal manometry) or a barium swallow. […] Your doctor can often find out the cause of esophageal spasm from your medical history by asking you a series of questions.

• #6 Esophageal Spasm | CommonSpirit Health

  https://www.commonspirit.org/conditions-treatments/esophageal-spasm

  Your doctor can often find out the cause of esophageal spasm from your medical history by asking you a series of questions. These include questions about what foods or liquids trigger symptoms, where it feels like food gets stuck, other symptoms or conditions you may have, and whether you are taking medicines for them. […] The diagnosis can be confirmed with tests, including esophagus tests (such as esophageal manometry) or a barium swallow. Esophageal manometry uses a small tube attached to instruments (transducers) that measure pressure. A barium swallow is done using X-rays. […] Other tests may be done to find out whether chest pain may be caused by gastroesophageal reflux disease (GERD), the abnormal backflow (reflux) of food, stomach acid, and other digestive juices from the stomach into the esophagus.

• #7 Esophageal Spasm – Grand Ave Urgent Care

  https://grandaveurgentcare.com/patient-education/health-library?DOCHWID=ut1638spec

  Esophageal spasm is not common. Often, symptoms may suggest that esophageal spasm is the result of another condition. […] The diagnosis can be confirmed with tests, including esophagus tests (such as esophageal manometry) or a barium swallow. […] Your doctor can often find out the cause of esophageal spasm from your medical history by asking you a series of questions.

• #8 Esophageal Spasm – Chicago Colorectal

  https://chicagocolorectal.com/patient-education/healthwise?DOCHWID=ut1638spec

  Esophageal spasm is not common. Often, symptoms may suggest that esophageal spasm is the result of another condition. […] The diagnosis can be confirmed with tests, including esophagus tests (such as esophageal manometry) or a barium swallow. Esophageal manometry uses a small tube attached to instruments (transducers) that measure pressure. A barium swallow is done using X-rays. […] Your doctor can often find out the cause of esophageal spasm from your medical history by asking you a series of questions. These include questions about what foods or liquids trigger symptoms, where it feels like food gets stuck, other symptoms or conditions you may have, and whether you are taking medicines for them.

• #9 Esophageal spasm – WikEM

  https://wikem.org/wiki/Esophageal_spasm

  Strong spasms of the musculature of the esophagus that can last minutes to hours and mimic the chest pain of angina […] Esophageal spasm is a diagnosis of exclusion. Work-up should focus on ruling out more serious etiologies. […] Diagnosis of exclusion […] Upper gastrointestinal endoscopy with esophageal biopsies obtained to rule out other causes […] Followed by esophageal manometry.

• #10 Esophageal spasms

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20372236

  Esophageal spasms are painful contractions within the muscular tube connecting your mouth and stomach. […] Esophageal spasms typically occur only occasionally and might not need treatment. […] If esophageal spasms interfere with your ability to eat or drink, treatments are available. […] The squeezing chest pain associated with esophageal spasms also can be caused by a heart attack. If you experience squeezing chest pain, seek immediate medical care. […] Your health care provider might recommend: Esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when you swallow, the coordination and force exerted by the esophagus muscles, and how well your lower esophageal sphincter relaxes or opens during a swallow. […] X-rays of your upper digestive system, also called an esophagram. X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract.

• #11 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Your healthcare provider will perform a physical exam to evaluate your symptoms. If you have chest pain, your provider may order tests, such as an electrocardiogram (EKG), to rule out heart disease. […] Once theyve ruled out heart disease, theyll likely perform tests to rule out more common conditions that may be causing your symptoms. These include: […] Tests used to diagnose esophageal spasms specifically include: […] Esophageal manometry: This test measures pressure waves inside your esophagus when you swallow. Its the gold-standard (most used and reliable) test to diagnose esophageal spasms. An unusually large number of simultaneous contractions in your lower esophagus is a major indicator of spasms. […] Esophageal spasms can be tricky to diagnose since several conditions cause the telltale symptoms: chest pain and trouble swallowing. […] Once your provider determines your issue isnt heart-related, theyll rule out more common digestive system conditions with similar symptoms.

• #12 Esophageal spasm: Causes, symptoms, and treatments

  https://www.medicalnewstoday.com/articles/320926

  A doctor can diagnose esophageal spasm by performing several tests. […] Initially, they are likely to rule out any more serious conditions, such as angina, by performing a cardiac test, for example, an EKG. […] Other tests include: […] Esophageal manometry: Muscle contractions of the esophagus are measured while water is swallowed. […] Barium swallow: A person is asked to drink a contrast liquid, and an X-ray is then taken. The liquid helps doctors to get a better view of the esophagus. […] Endoscopy: Performing an endoscopy involves a thin tube being put into a persons throat. The tube has a light and camera on it that allows a doctor to see inside of the esophagus. […] Esophageal pH monitoring: A test that measures the pH balance of the esophagus to show if a person has acid reflux.

• #13 Oesophageal Spasm: Symptoms and Treatment | Doctor

  https://patient.info/doctor/oesophageal-spasm

  Oesophageal spasm may be diagnosed following investigation of non-cardiac chest pain or dysphagia. […] Upper gastrointestinal endoscopy is no longer routinely recommended but is indicated in symptomatic patients (chest pain, dysphagia or reflux). […] Oesophageal manometry: Continuous spatiotemporal representations of pressure through the oesophagus, recorded with HRM, offer greater detail and improved accuracy for many of the most important measurements of oesophageal motor function. It is particularly helpful in patients with dysphagia, DOS and HO. […] 24-hour ambulatory manometry may be more useful than standard, laboratory-based manometry. […] Barium swallow may be helpful if endoscopy is contra-indicated but structural problems need to be excluded. […] Cardiac investigations: Are often indicated (or will have already been done) to rule out cardiac causes of chest pain.

• #14 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Your healthcare provider will perform a physical exam to evaluate your symptoms. If you have chest pain, your provider may order tests, such as an electrocardiogram (EKG), to rule out heart disease. […] Once theyve ruled out heart disease, theyll likely perform tests to rule out more common conditions that may be causing your symptoms. These include: […] Tests used to diagnose esophageal spasms specifically include: […] Esophageal manometry: This test measures pressure waves inside your esophagus when you swallow. Its the gold-standard (most used and reliable) test to diagnose esophageal spasms. An unusually large number of simultaneous contractions in your lower esophagus is a major indicator of spasms. […] Esophageal spasms can be tricky to diagnose since several conditions cause the telltale symptoms: chest pain and trouble swallowing. […] Once your provider determines your issue isnt heart-related, theyll rule out more common digestive system conditions with similar symptoms.

• #15 Esophageal Spasm: Causes, Symptoms, Treatments, & Diagnosis

  https://www.webmd.com/digestive-disorders/what-is-esophageal-spasm

  Esophageal Spasm Diagnosis […] Because spasms cause symptoms similar to a heart attack, your doctor will first run tests to check your heart health. Its important to rule out angina, a type of chest pain caused by coronary artery disease. […] Your doctor also will check for signs of gastroesophageal reflux disease (GERD), which can cause heartburn and make it hard to swallow. You can have both GERD and esophageal spasms. […] Tests your doctor may order include: […] Manometry. This is the only test that can confirm esophageal spasms. During this procedure, the doctor inserts a thin tube into your esophagus. Sensors on the tube measure pressure in the esophagus and reveal how well the muscles relax when you swallow. […] If you have repeated episodes of chest pain but your doctor has ruled out heart problems and GERD, talk to them about this condition. Esophageal spasms that come and go sometimes take years to diagnose.

• #16 Esophageal spasm – Wikipedia

  https://en.wikipedia.org/wiki/Esophageal_spasm

  Esophageal spasm is a disorder of motility of the esophagus. […] The diagnosis is generally confirmed by esophageal manometry. DES is present when more than a fifth of swallows results in distal esophageal contractions. NE is present if the average strength of the contractions of the distal esophagus is greater than 180 mmHg but the contraction of the esophagus is otherwise normal. […] Often, symptoms that may suggest esophageal spasm are the result of another condition such as food intolerance, gastroesophageal reflux disease (GERD) or achalasia.

• #17 Esophageal Spasm Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/174975-workup

  Laboratory evaluation usually does not aid in the diagnosis if the patient’s history and physical examination findings are unremarkable for other diseases mentioned in the differential diagnosis. All differentials mentioned can present with esophageal dysmotility. […] The diagnostic modalities of choice are barium swallow and esophageal manometry. […] Barium swallow or esophagram is the best imaging study to aid in the diagnosis of esophageal spasm by evaluating for nonpropulsive contractions in the esophagus. […] Manometry is the best modality to help diagnose diffuse esophageal spasm as well as esophageal spasm as the cause of noncardiac chest pain. […] The classic definition is more than 2 uncoordinated contractions during 10 consecutive wet swallows (20% simultaneous esophageal contractions during standardized stationary motility testing). At least one peristaltic contraction must be present.

• #18 Esophageal Spasms: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/15575-esophageal-spasms

  Your healthcare provider will perform a physical exam to evaluate your symptoms. If you have chest pain, your provider may order tests, such as an electrocardiogram (EKG), to rule out heart disease. […] Once theyve ruled out heart disease, theyll likely perform tests to rule out more common conditions that may be causing your symptoms. These include: […] Tests used to diagnose esophageal spasms specifically include: […] Esophageal manometry: This test measures pressure waves inside your esophagus when you swallow. Its the gold-standard (most used and reliable) test to diagnose esophageal spasms. An unusually large number of simultaneous contractions in your lower esophagus is a major indicator of spasms. […] Esophageal spasms can be tricky to diagnose since several conditions cause the telltale symptoms: chest pain and trouble swallowing. […] Once your provider determines your issue isnt heart-related, theyll rule out more common digestive system conditions with similar symptoms.

• #19 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://www.wjgnet.com/2307-8960/full/v8/i6/1026.htm

  Distal esophageal spasm (DES) is diagnosed by finding of 20% premature contractions, with normal lower esophageal sphincter (LES) relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0. […] In addition to HRM, ancillary tests such as endoscopy and barium esophagram can provide supplemental information to differentiate DES from other conditions. […] HRM is the gold standard for the diagnosis of DES. The CC v3.0 classifies DES as a major motility disorder and defines DES by findings of premature contractions [distal latency (DL) 4.5 s] in at least 20% of wet swallows, in conjunction with normal LES relaxation measured by integrated relaxation pressure 15 mmHg. […] The previously used criteria of rapid contractions, defined as contractile front velocity greater than 9 cm/s, to diagnose DES was removed from the CC v3.0 as this was shown to be non-specific and can be seen in normal subjects and in other esophageal motility disorders.

• #20 Distal Esophageal Spasm – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/distal-esophageal-spasm

  Symptomatic distal esophageal spasm (formerly called diffuse esophageal spasm) is part of a spectrum of motility disorders characterized variously by nonpropulsive contractions and hyperdynamic contractions, sometimes in conjunction with elevated lower esophageal sphincter pressure. […] Diagnosis is by barium swallow or manometry. […] Barium swallow may show poor progression of a bolus and disordered, simultaneous contractions or tertiary contractions. […] Esophageal manometry provides the most specific description of the spasms. […] Definitive confirmation of an esophageal origin for symptoms is difficult. […] At least 20% of test swallows must have a short distal latency.

• #21 Esophageal spasms – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/diagnosis-treatment/drc-20372255

  During an upper endoscopy, a healthcare professional inserts a thin, flexible tube equipped with a light and camera down the throat and into the esophagus. […] To diagnose esophageal spasms, a healthcare professional may recommend: […] Upper endoscopy. An upper endoscopy uses a tiny camera on the end of a flexible tube to visually examine the upper digestive system. Endoscopy also can be used to collect a sample of tissue to be tested for other esophageal diseases. This tissue sample is known as a biopsy. […] X-rays of the upper digestive system, also called an esophagram. X-rays are taken after drinking a chalky liquid that coats and fills the inside lining of the digestive tract. The coating allows a specialist to see a silhouette of the esophagus, stomach and upper intestine. […] Esophageal manometry. This test measures the rhythmic muscle contractions in the esophagus when swallowing; the coordination and force exerted by the esophagus muscles; and how well the lower esophageal sphincter relaxes or opens during a swallow.

• #22 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7103967/

  Distal esophageal spasm (DES) is diagnosed by finding of 20% premature contractions, with normal lower esophageal sphincter (LES) relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0. […] Currently, the specific characteristics of DES on HRM are premature contractions ( 20% of wet swallows) and normal relaxation of lower esophageal sphincter (LES). […] HRM is the gold standard for the diagnosis of DES. The CC v3.0 classifies DES as a major motility disorder and defines DES by findings of premature contractions [distal latency (DL) 4.5 s] in at least 20% of wet swallows, in conjunction with normal LES relaxation measured by integrated relaxation pressure 15 mmHg. […] The previously used criteria of rapid contractions, defined as contractile front velocity greater than 9 cm/s, to diagnose DES was removed from the CC v3.0 as this was shown to be non-specific and can be seen in normal subjects and in other esophageal motility disorders.

• #23 Esophageal hypermotility disorders – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/esophageal-hypermotility-disorders/

  High-resolution esophageal manometry (HRM) is the gold standard for diagnosing esophageal motility disorders. […] Distal esophageal spasm is diagnosed by measuring the duration of latency periods. Hypercontractile esophagus and hypertensive peristalsis are diagnosed by measuring the strength of peristalsis.

• #24 Esophageal Spasm Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/174975-workup

  Esophageal manometry and pH monitoring are crucial to distinguish between primary and secondary esophageal motility disorders and to guide appropriate therapy. […] Esophageal manometry may be combined with multichannel intraluminal impedance to obtain pressure and bolus transit information. […] Esophageal pH recording and 24-hour ambulatory manometry may improve the detection of esophageal muscle dysfunction.

• #25 Oesophageal Spasm: Symptoms and Treatment | Doctor

  https://patient.info/doctor/oesophageal-spasm

  Oesophageal spasm may be diagnosed following investigation of non-cardiac chest pain or dysphagia. […] Upper gastrointestinal endoscopy is no longer routinely recommended but is indicated in symptomatic patients (chest pain, dysphagia or reflux). […] Oesophageal manometry: Continuous spatiotemporal representations of pressure through the oesophagus, recorded with HRM, offer greater detail and improved accuracy for many of the most important measurements of oesophageal motor function. It is particularly helpful in patients with dysphagia, DOS and HO. […] 24-hour ambulatory manometry may be more useful than standard, laboratory-based manometry. […] Barium swallow may be helpful if endoscopy is contra-indicated but structural problems need to be excluded. […] Cardiac investigations: Are often indicated (or will have already been done) to rule out cardiac causes of chest pain.

• #26 Esophageal Spasm – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/esophageal-and-swallowing-disorders/esophageal-spasm

  Esophageal spasm is a disorder of the rhythmic waves of muscular contractions (peristalsis) of the esophagus. […] The diagnosis is based on the results of barium swallow x-rays and manometry. […] Doctors do a barium swallow. In this test, people are given barium in a liquid before x-rays are taken. The barium outlines the esophagus, making abnormalities easier to see. This test may show that the barium does not move normally down the esophagus and that some of the contractions of the esophageal wall are uncoordinated and do not move the barium. […] Pressure measurements by manometry (a test in which a tube placed in the esophagus measures the pressure of contractions) provide the most sensitive and detailed analysis of the spasms.

• #27 Diffuse Esophageal Spasm | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/diffuse-esophageal-spasm.html

  This condition can be diagnosed using: […] A barium swallow. X-rays taken of the esophagus while the patient swallows barium show an uncoordinated esophagus that sometimes looks like a corkscrew. Uncoordinated contractions may keep the barium from moving to the stomach. […] Esophageal manometry. This test identifies when the muscles are tightening (contracting) without being coordinated. […] Upper GI endoscopy is almost always performed if a patient describes food sticking in the esophagus after swallowing. This process involves putting a flexible tube with a tiny camera down the individual’s throat so that the doctor can see inside the esophagus. This procedure can be help detect tumors, unusual masses or scars.

• #28 Esophageal Spasm Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/174975-workup

  Laboratory evaluation usually does not aid in the diagnosis if the patient’s history and physical examination findings are unremarkable for other diseases mentioned in the differential diagnosis. All differentials mentioned can present with esophageal dysmotility. […] The diagnostic modalities of choice are barium swallow and esophageal manometry. […] Barium swallow or esophagram is the best imaging study to aid in the diagnosis of esophageal spasm by evaluating for nonpropulsive contractions in the esophagus. […] Manometry is the best modality to help diagnose diffuse esophageal spasm as well as esophageal spasm as the cause of noncardiac chest pain. […] The classic definition is more than 2 uncoordinated contractions during 10 consecutive wet swallows (20% simultaneous esophageal contractions during standardized stationary motility testing). At least one peristaltic contraction must be present.

• #29 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://www.wjgnet.com/2307-8960/full/v8/i6/1026.htm

  Another relatively new technologic tool is the functional lumen imaging probe (FLIP) which is increasingly being utilized as an additional diagnostic instrument in evaluating esophageal disorders. […] Although DES has been refined into a more homogenous disorder using specific criteria on HRM, its clinical presentation is heterogenous. The most common symptoms of DES include dysphagia (55%) followed by chest pain (29%). […] Findings on ancillary tests such as endoscopy and barium esophagram are not specific to DES, but they can provide important clues toward the diagnosis. […] The corkscrew appearance results from tertiary, non-propulsive contractions of the esophagus circular muscles. […] DES and spastic achalasia (achalasia type 3) appear to share a common pathophysiologic pathway. […] In cases with persistent symptoms despite medical therapy, endoscopic treatment interventions with botulinum toxin injection and Peroral endoscopic myotomy (POEM) should be considered.

• #30 Diffuse esophageal spasm | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/diffuse-oesophageal-spasm?lang=us

  Diffuse/distal esophageal spasm (DOS) is a motility disorder of the esophagus. Manometry is the gold standard diagnostic test. […] On barium swallow, diffuse esophageal spasm may appear as a corkscrew esophagus, but this is uncommon. […] Diffuse esophageal spasm differs from hypercontracting esophagus (nutcracker esophagus).

• #31 Distal Esophageal Spasm – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/distal-esophageal-spasm

  Symptomatic distal esophageal spasm (formerly called diffuse esophageal spasm) is part of a spectrum of motility disorders characterized variously by nonpropulsive contractions and hyperdynamic contractions, sometimes in conjunction with elevated lower esophageal sphincter pressure. […] Diagnosis is by barium swallow or manometry. […] Barium swallow may show poor progression of a bolus and disordered, simultaneous contractions or tertiary contractions. […] Esophageal manometry provides the most specific description of the spasms. […] Definitive confirmation of an esophageal origin for symptoms is difficult. […] At least 20% of test swallows must have a short distal latency.

• #32 Esophageal spasms – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/diagnosis-treatment/drc-20372255

  During an upper endoscopy, a healthcare professional inserts a thin, flexible tube equipped with a light and camera down the throat and into the esophagus. […] To diagnose esophageal spasms, a healthcare professional may recommend: […] Upper endoscopy. An upper endoscopy uses a tiny camera on the end of a flexible tube to visually examine the upper digestive system. Endoscopy also can be used to collect a sample of tissue to be tested for other esophageal diseases. This tissue sample is known as a biopsy. […] X-rays of the upper digestive system, also called an esophagram. X-rays are taken after drinking a chalky liquid that coats and fills the inside lining of the digestive tract. The coating allows a specialist to see a silhouette of the esophagus, stomach and upper intestine. […] Esophageal manometry. This test measures the rhythmic muscle contractions in the esophagus when swallowing; the coordination and force exerted by the esophagus muscles; and how well the lower esophageal sphincter relaxes or opens during a swallow.

• #33 Esophageal Spasm – What You Need to Know

  https://www.drugs.com/cg/esophageal-spasm.html

  How is esophageal spasm diagnosed? […] You may receive the following tests: […] Manometry: Your healthcare provider will gently insert a tube into your throat and down into your stomach. The tube has sensors on it that measure the pressure in your esophagus. This pressure shows the strength of the spasms when you swallow. The test also shows how well food and fluids move down your esophagus when you swallow. […] Endoscopy: Your healthcare provider will gently place a scope (long tube with a small camera on the end) into your throat to check for problems with the shape of your esophagus. Your healthcare provider may also check the thickness of your esophagus. Samples of your esophagus tissue may be taken and sent to a lab for tests. […] X-ray with barium swallow: An x-ray of your abdomen is a picture of your stomach and esophagus. You will drink a thick liquid called barium to help your esophagus and stomach show up better on the x-ray. Follow the instructions from your healthcare provider before and after the x-ray test.

• #34 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://www.wjgnet.com/2307-8960/full/v8/i6/1026.htm

  Another relatively new technologic tool is the functional lumen imaging probe (FLIP) which is increasingly being utilized as an additional diagnostic instrument in evaluating esophageal disorders. […] Although DES has been refined into a more homogenous disorder using specific criteria on HRM, its clinical presentation is heterogenous. The most common symptoms of DES include dysphagia (55%) followed by chest pain (29%). […] Findings on ancillary tests such as endoscopy and barium esophagram are not specific to DES, but they can provide important clues toward the diagnosis. […] The corkscrew appearance results from tertiary, non-propulsive contractions of the esophagus circular muscles. […] DES and spastic achalasia (achalasia type 3) appear to share a common pathophysiologic pathway. […] In cases with persistent symptoms despite medical therapy, endoscopic treatment interventions with botulinum toxin injection and Peroral endoscopic myotomy (POEM) should be considered.

• #35 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Diffuse esophageal spasm is an esophageal motility disorder that often manifests as dysphagia. If the diagnosis is delayed, diffuse esophageal spasm is associated with high morbidity. […] Explain the techniques used to diagnose diffuse esophageal spasms. […] Evaluation of non-cardiac chest pain in older patients, males, white race, and those presenting with dysphagia are candidates for esophageal function testing. […] Twenty-four-hour manometry is the best modality to diagnose DES as a cause of noncardiac chest pain and should be combined with endoscopy and barium swallow to rule out any kind of inflammation and neoplasia in the esophagus. […] Although the diagnosis is usually made by means of esophageal manometry, tests like endoscopy and barium swallow are helpful in excluding inflammatory or neoplastic changes. […] The introduction of newer techniques like high-resolution manometry (HRM) and esophageal pressure topography (EPT) has significantly enhanced the ability to diagnose DES.

• #36 Distal esophageal spasm and hypercontractile esophagus – UpToDate

  https://www.uptodate.com/contents/distal-esophageal-spasm-and-hypercontractile-esophagus

  Patients with esophageal dysmotility may present with dysphagia, noncardiac chest pain, food impaction, heartburn and/or regurgitation. After inflammatory and structural abnormalities are excluded by performing an upper gastrointestinal endoscopy (esophagogastroduodenoscopy), esophageal manometry is often performed to assess esophageal motor function. […] This topic will review the pathophysiology, clinical features, diagnosis, and management of the following disorders of esophageal peristalsis: distal esophageal spasm (DES; formerly diffuse esophageal spasm) and hypercontractile (formerly jackhammer) esophagus (HE). […] The evaluation of chest pain of esophageal origin is discussed separately. […] The evaluation of chest pain of nonesophageal origin is also addressed separately.

• #37 Esophageal spasms – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/diagnosis-treatment/drc-20372255

  During an upper endoscopy, a healthcare professional inserts a thin, flexible tube equipped with a light and camera down the throat and into the esophagus. […] To diagnose esophageal spasms, a healthcare professional may recommend: […] Upper endoscopy. An upper endoscopy uses a tiny camera on the end of a flexible tube to visually examine the upper digestive system. Endoscopy also can be used to collect a sample of tissue to be tested for other esophageal diseases. This tissue sample is known as a biopsy. […] X-rays of the upper digestive system, also called an esophagram. X-rays are taken after drinking a chalky liquid that coats and fills the inside lining of the digestive tract. The coating allows a specialist to see a silhouette of the esophagus, stomach and upper intestine. […] Esophageal manometry. This test measures the rhythmic muscle contractions in the esophagus when swallowing; the coordination and force exerted by the esophagus muscles; and how well the lower esophageal sphincter relaxes or opens during a swallow.

• #38 Esophageal Motility Disorder/Eosinophilic Esophagitis – Midtown East/Upper East Side New York, NY

  https://www.alberthararymd.com/contents/conditions-we-treat/esophageal-motility-disorder

  Esophageal manometry, also called esophageal motility testing or esophageal function testing, is one of the most useful tests to evaluate swallowing disorders. […] The diagnosis of diffuse esophageal spasm is made by esophageal manometry, which shows frequent simultaneous contractions mixed with normal peristalsis contractions. […] Eosinophilic esophagitis is diagnosed by upper GI endoscopy (EGD), in which large numbers of eosinophils are found in biopsies of the lining of the esophagus. […] A video-esophagram x-ray, upper GI endoscopy (EGD), and esophageal manometry are used in the evaluation of esophageal problems in scleroderma.

• #39 Esophageal Spasm: Symptoms, Causes, Treatment and More

  https://www.healthline.com/health/esophageal-spasm

  Esophageal spasms are typically rare, but they may occur with frequency in some people. This can inhibit your ability to eat and drink. When esophageal spasms happen often, they may require treatment. […] Your doctor may first rule out angina by giving you an EKG, stress test, or another cardiac test. Diagnostic tests for esophageal spasms include: Esophageal manometry: This measures muscle contractions while you swallow water. Barium swallow: This X-ray imaging test requires you to drink a contrast liquid to offer a better view of your esophagus. Endoscopy: During endoscopy, a thin, flexible tube, called an endoscope, is inserted down your throat. This allows your doctor to view the inside of your esophagus. Esophageal pH monitoring: This test checks for acid reflux and regurgitation by measuring the pH balance in your esophagus.

• #40 Esophageal Spasm Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/174975-workup

  Esophageal manometry and pH monitoring are crucial to distinguish between primary and secondary esophageal motility disorders and to guide appropriate therapy. […] Esophageal manometry may be combined with multichannel intraluminal impedance to obtain pressure and bolus transit information. […] Esophageal pH recording and 24-hour ambulatory manometry may improve the detection of esophageal muscle dysfunction.

• #41 Esophageal Dysmotility | Loma Linda University Health

  https://lluh.org/conditions/esophageal-dysmotility

  If a doctor suspects esophageal dysmotility, the diagnosis will begin with a physical examination and discussion of health history. […] Tests and imaging techniques used to diagnose esophageal dysmotility might include: […] Barium swallow study These studies help to evaluate esophageal dysmotility […] Endoscopy This is used to look directly at the inner walls of the esophagus to evaluate the dysmotility. It is also used to exclude the presence of a tumor […] Endoscopic ultrasound (EUS) This is a procedure that combines endoscopy and ultrasound – this produces images and provides information about the digestive tract, surrounding tissue and organs […] Esophageal manometry This procedure is used to measure the function of the esophageal muscle […] pH study This study is done to assess for abnormal reflux.

• #42 Evaluation of the adult with chest pain of esophageal origin – UpToDate

  https://www.uptodate.com/contents/evaluation-of-the-adult-with-chest-pain-of-esophageal-origin

  GERD is the most likely cause for recurring unexplained chest pain of esophageal origin. […] Approximately 50 percent of patients with recurrent noncardiac chest pain have abnormal esophageal acid exposure. […] While an empiric diagnosis of „esophageal spasm” was previously applied to patients with unexplained noncardiac chest pain of esophageal origin, underlying esophageal motility disorders (eg, achalasia, distal esophageal spasm, jackhammer esophagus) are uncommon.

• #43 Evaluation of the adult with chest pain of esophageal origin – UpToDate

  https://www.uptodate.com/contents/evaluation-of-the-adult-with-chest-pain-of-esophageal-origin

  GERD is the most likely cause for recurring unexplained chest pain of esophageal origin. […] Approximately 50 percent of patients with recurrent noncardiac chest pain have abnormal esophageal acid exposure. […] While an empiric diagnosis of „esophageal spasm” was previously applied to patients with unexplained noncardiac chest pain of esophageal origin, underlying esophageal motility disorders (eg, achalasia, distal esophageal spasm, jackhammer esophagus) are uncommon.

• #44 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7103967/

  Another relatively new technologic tool is the functional lumen imaging probe (FLIP) which is increasingly being utilized as an additional diagnostic instrument in evaluating esophageal disorders. […] In cases with persistent symptoms despite medical therapy, endoscopic treatment interventions with botulinum toxin injection and Peroral endoscopic myotomy (POEM) should be considered. […] POEM appears to be a promising option when expertise is available; and botulinum toxin injection is a temporary therapeutic option, especially in high risk surgical patients.

• #45 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://www.wjgnet.com/2307-8960/full/v8/i6/1026.htm

  Another relatively new technologic tool is the functional lumen imaging probe (FLIP) which is increasingly being utilized as an additional diagnostic instrument in evaluating esophageal disorders. […] Although DES has been refined into a more homogenous disorder using specific criteria on HRM, its clinical presentation is heterogenous. The most common symptoms of DES include dysphagia (55%) followed by chest pain (29%). […] Findings on ancillary tests such as endoscopy and barium esophagram are not specific to DES, but they can provide important clues toward the diagnosis. […] The corkscrew appearance results from tertiary, non-propulsive contractions of the esophagus circular muscles. […] DES and spastic achalasia (achalasia type 3) appear to share a common pathophysiologic pathway. […] In cases with persistent symptoms despite medical therapy, endoscopic treatment interventions with botulinum toxin injection and Peroral endoscopic myotomy (POEM) should be considered.

• #46 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7103967/

  Another relatively new technologic tool is the functional lumen imaging probe (FLIP) which is increasingly being utilized as an additional diagnostic instrument in evaluating esophageal disorders. […] In cases with persistent symptoms despite medical therapy, endoscopic treatment interventions with botulinum toxin injection and Peroral endoscopic myotomy (POEM) should be considered. […] POEM appears to be a promising option when expertise is available; and botulinum toxin injection is a temporary therapeutic option, especially in high risk surgical patients.

• #47 Esophageal Spasm Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/174975-workup

  Esophageal manometry and pH monitoring are crucial to distinguish between primary and secondary esophageal motility disorders and to guide appropriate therapy. […] Esophageal manometry may be combined with multichannel intraluminal impedance to obtain pressure and bolus transit information. […] Esophageal pH recording and 24-hour ambulatory manometry may improve the detection of esophageal muscle dysfunction.

• #48 Esophageal Spasm Differential Diagnoses

  https://emedicine.medscape.com/article/174975-differential

  Studies using catheter-based high-frequency ultrasound imaging have shown an increase in the baseline muscle thickness in patients with diffuse esophageal spasm, nutcracker esophagus, and achalasia, as well as in patients with esophageal symptoms and normal static manometry. […] Esophageal spasm can modify cardiac function and vice versa. Esophageal spasm and coronary artery disease may coexist. Mechanisms that cause esophageal spasm can feed back to cause coronary spasm, and coronary spasm may feed forward to cause further esophageal spasm.

• #49 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7103967/

  Distal esophageal spasm (DES) is diagnosed by finding of 20% premature contractions, with normal lower esophageal sphincter (LES) relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0. […] Currently, the specific characteristics of DES on HRM are premature contractions ( 20% of wet swallows) and normal relaxation of lower esophageal sphincter (LES). […] HRM is the gold standard for the diagnosis of DES. The CC v3.0 classifies DES as a major motility disorder and defines DES by findings of premature contractions [distal latency (DL) 4.5 s] in at least 20% of wet swallows, in conjunction with normal LES relaxation measured by integrated relaxation pressure 15 mmHg. […] The previously used criteria of rapid contractions, defined as contractile front velocity greater than 9 cm/s, to diagnose DES was removed from the CC v3.0 as this was shown to be non-specific and can be seen in normal subjects and in other esophageal motility disorders.

• #50 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://www.wjgnet.com/2307-8960/full/v8/i6/1026.htm

  Distal esophageal spasm (DES) is diagnosed by finding of 20% premature contractions, with normal lower esophageal sphincter (LES) relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0. […] In addition to HRM, ancillary tests such as endoscopy and barium esophagram can provide supplemental information to differentiate DES from other conditions. […] HRM is the gold standard for the diagnosis of DES. The CC v3.0 classifies DES as a major motility disorder and defines DES by findings of premature contractions [distal latency (DL) 4.5 s] in at least 20% of wet swallows, in conjunction with normal LES relaxation measured by integrated relaxation pressure 15 mmHg. […] The previously used criteria of rapid contractions, defined as contractile front velocity greater than 9 cm/s, to diagnose DES was removed from the CC v3.0 as this was shown to be non-specific and can be seen in normal subjects and in other esophageal motility disorders.

• #51 Distal Esophageal Spasm – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/distal-esophageal-spasm

  Symptomatic distal esophageal spasm (formerly called diffuse esophageal spasm) is part of a spectrum of motility disorders characterized variously by nonpropulsive contractions and hyperdynamic contractions, sometimes in conjunction with elevated lower esophageal sphincter pressure. […] Diagnosis is by barium swallow or manometry. […] Barium swallow may show poor progression of a bolus and disordered, simultaneous contractions or tertiary contractions. […] Esophageal manometry provides the most specific description of the spasms. […] Definitive confirmation of an esophageal origin for symptoms is difficult. […] At least 20% of test swallows must have a short distal latency.

• #52 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7103967/

  Distal esophageal spasm (DES) is diagnosed by finding of 20% premature contractions, with normal lower esophageal sphincter (LES) relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0. […] Currently, the specific characteristics of DES on HRM are premature contractions ( 20% of wet swallows) and normal relaxation of lower esophageal sphincter (LES). […] HRM is the gold standard for the diagnosis of DES. The CC v3.0 classifies DES as a major motility disorder and defines DES by findings of premature contractions [distal latency (DL) 4.5 s] in at least 20% of wet swallows, in conjunction with normal LES relaxation measured by integrated relaxation pressure 15 mmHg. […] The previously used criteria of rapid contractions, defined as contractile front velocity greater than 9 cm/s, to diagnose DES was removed from the CC v3.0 as this was shown to be non-specific and can be seen in normal subjects and in other esophageal motility disorders.

• #53 Esophageal spasms – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-spasms/symptoms-causes/syc-20372250

  Esophageal spasms usually happen only now and then, and they might not need treatment. But sometimes the spasms happen a lot and can prevent food and liquids from traveling through the esophagus. If esophageal spasms affect the ability to eat or drink, treatments are available. […] The squeezing chest pain that happens with esophageal spasms also can be caused by a heart attack. If you have squeezing chest pain, seek medical care right away. […] It’s not clear what causes esophageal spasms. However, they appear to be related to abnormal functioning of nerves that control the muscles used when swallowing. […] Esophageal spasms make it difficult for the muscles in the walls of the lower esophagus to coordinate. This makes it harder for the muscles to move food to the stomach. […] There are two types of esophageal spasms distal esophageal spasm and hypercontractile esophagus, also known as nutcracker esophagus. […] Risk factors for esophageal spasms include: Women are more likely to have esophageal spasms than men. Esophageal spasms tend to happen around age 60.

• #54 Oesophageal Spasm: Symptoms and Treatment | Doctor

  https://patient.info/doctor/oesophageal-spasm

  Oesophageal spasm may be diagnosed following investigation of non-cardiac chest pain or dysphagia. […] Upper gastrointestinal endoscopy is no longer routinely recommended but is indicated in symptomatic patients (chest pain, dysphagia or reflux). […] Oesophageal manometry: Continuous spatiotemporal representations of pressure through the oesophagus, recorded with HRM, offer greater detail and improved accuracy for many of the most important measurements of oesophageal motor function. It is particularly helpful in patients with dysphagia, DOS and HO. […] 24-hour ambulatory manometry may be more useful than standard, laboratory-based manometry. […] Barium swallow may be helpful if endoscopy is contra-indicated but structural problems need to be excluded. […] Cardiac investigations: Are often indicated (or will have already been done) to rule out cardiac causes of chest pain.

• #55 Esophageal hypermotility disorders – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/esophageal-hypermotility-disorders/

  Esophageal hypermotility disorders are a group of uncommon conditions that include hypercontractile peristalsis, which is caused by vigorous esophageal contractions, and distal esophageal spasm, which is caused by premature esophageal contractions. […] It is important to rule out more common causes of acute chest pain and dysphagia before considering high-resolution esophageal manometry (HRM) to confirm a diagnosis of esophageal hypermotility. […] Manometry is the mainstay of diagnosis for esophageal hypermotility disorders but should be considered only after the more common structural and inflammatory esophageal conditions have been ruled out. […] Obtain high-resolution esophageal manometry (HRM) if the index of suspicion for esophageal hypermotility disorders is high or if endoscopy and esophageal barium swallow are inconclusive.

• #56 Esophageal Motility Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0901/p291.html

  Esophageal motility disorders can cause chest pain, heartburn, or dysphagia. They are diagnosed based on specific patterns seen on esophageal manometry, ranging from the complete absence of contractility in patients with achalasia to unusually forceful or disordered contractions in those with hypercontractile motility disorders. […] Dysphagia of liquids in a patient with normal esophagogastroduodenoscopy findings may suggest achalasia, but high-resolution esophageal manometry is required to confirm the diagnosis. […] High-resolution manometry is required to confirm the diagnosis of achalasia. […] Manometry is required to confirm the diagnosis of achalasia. […] Testing for esophageal motility disorders should be done judiciously to avoid overdiagnosis. […] Manometry is indicated in patients who continue to have dysphagia and chest pain despite optimal medical management, especially those who have normal EGD findings and persistent dysphagia to liquids.

• #57 Esophageal hypermotility disorders – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/esophageal-hypermotility-disorders/

  Esophageal hypermotility disorders are a group of uncommon conditions that include hypercontractile peristalsis, which is caused by vigorous esophageal contractions, and distal esophageal spasm, which is caused by premature esophageal contractions. […] It is important to rule out more common causes of acute chest pain and dysphagia before considering high-resolution esophageal manometry (HRM) to confirm a diagnosis of esophageal hypermotility. […] Manometry is the mainstay of diagnosis for esophageal hypermotility disorders but should be considered only after the more common structural and inflammatory esophageal conditions have been ruled out. […] Obtain high-resolution esophageal manometry (HRM) if the index of suspicion for esophageal hypermotility disorders is high or if endoscopy and esophageal barium swallow are inconclusive.

• #58 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Diffuse esophageal spasm is an esophageal motility disorder that often manifests as dysphagia. If the diagnosis is delayed, diffuse esophageal spasm is associated with high morbidity. […] Explain the techniques used to diagnose diffuse esophageal spasms. […] Evaluation of non-cardiac chest pain in older patients, males, white race, and those presenting with dysphagia are candidates for esophageal function testing. […] Twenty-four-hour manometry is the best modality to diagnose DES as a cause of noncardiac chest pain and should be combined with endoscopy and barium swallow to rule out any kind of inflammation and neoplasia in the esophagus. […] Although the diagnosis is usually made by means of esophageal manometry, tests like endoscopy and barium swallow are helpful in excluding inflammatory or neoplastic changes. […] The introduction of newer techniques like high-resolution manometry (HRM) and esophageal pressure topography (EPT) has significantly enhanced the ability to diagnose DES.

• #59 Esophageal Motility Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0901/p291.html

  Esophageal motility disorders can cause chest pain, heartburn, or dysphagia. They are diagnosed based on specific patterns seen on esophageal manometry, ranging from the complete absence of contractility in patients with achalasia to unusually forceful or disordered contractions in those with hypercontractile motility disorders. […] Dysphagia of liquids in a patient with normal esophagogastroduodenoscopy findings may suggest achalasia, but high-resolution esophageal manometry is required to confirm the diagnosis. […] High-resolution manometry is required to confirm the diagnosis of achalasia. […] Manometry is required to confirm the diagnosis of achalasia. […] Testing for esophageal motility disorders should be done judiciously to avoid overdiagnosis. […] Manometry is indicated in patients who continue to have dysphagia and chest pain despite optimal medical management, especially those who have normal EGD findings and persistent dysphagia to liquids.

• #60 To your good health: Painful esophageal spasm needs expert diagnosis

  https://www.staugustine.com/story/lifestyle/2014/05/08/your-good-health-painful-esophageal-spasm-needs-expert-diagnosis/16117993007/

  Diffuse esophageal spasm is an uncommon disorder in which the nerves and muscles of the esophagus act abnormally during swallowing and can cause chest pain, heartburn, regurgitation or difficulty swallowing. […] It can be hard to diagnose definitively, with the „gold standard” for diagnosis being manometry, a measurement of the nerve impulses and pressures inside the esophagus, sometimes with a medication injected to see if it causes spasm. […] I think your daughter really needs an expert in this disorder. Gastroenterologists, who are themselves subspecialists, are not always familiar with this condition, and it may require a gastroenterologist who subsubspecializes in swallowing problems to properly diagnose and help your daughter.

• #61 Esophageal spasms

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20372236

  Upper endoscopy. Your provider inserts a thin, flexible tube equipped with a light and camera down your throat to examine the inside of your esophagus and stomach. […] Treatment depends on the frequency and severity of your esophageal spasms. […] If your spasms make it difficult to eat or drink, your provider might recommend: Managing any underlying conditions. […] Medicines to relax your swallowing muscles. […] Surgery (myotomy). If medicine doesn’t work, your provider might recommend a procedure that involves cutting the muscle at the lower end of the esophagus. […] Peroral endoscopic myotomy (POEM). The POEM procedure is minimally invasive. […] You may be referred to a health care provider who specializes in the digestive system, also called a gastroenterologist. […] What tests do I need? Is there any special preparation for them? […] What treatments are available?

• #62 Painful esophageal spasm needs expert diagnosis

  https://www.sunjournal.com/2014/05/08/painful-esophageal-spasm-needs-expert-diagnosis/

  Painful esophageal spasm needs expert diagnosis […] Diffuse esophageal spasm is an uncommon disorder in which the nerves and muscles of the esophagus act abnormally during swallowing and can cause chest pain, heartburn, regurgitation or difficulty swallowing. Its not really clear what causes it. I do know that the pain can be extreme in some cases. […] It can be hard to diagnose definitively, with the gold standard for diagnosis being manometry, a measurement of the nerve impulses and pressures inside the esophagus, sometimes with a medication injected to see if it causes spasm. […] I think your daughter really needs an expert in this disorder. Gastroenterologists, who are themselves subspecialists, are not always familiar with this condition, and it may require a gastroenterologist who subsubspecializes in swallowing problems to properly diagnose and help your daughter.

• #63 Esophageal Spasm: Causes, Symptoms, Treatments, & Diagnosis

  https://www.webmd.com/digestive-disorders/what-is-esophageal-spasm

  Esophageal Spasm Diagnosis […] Because spasms cause symptoms similar to a heart attack, your doctor will first run tests to check your heart health. Its important to rule out angina, a type of chest pain caused by coronary artery disease. […] Your doctor also will check for signs of gastroesophageal reflux disease (GERD), which can cause heartburn and make it hard to swallow. You can have both GERD and esophageal spasms. […] Tests your doctor may order include: […] Manometry. This is the only test that can confirm esophageal spasms. During this procedure, the doctor inserts a thin tube into your esophagus. Sensors on the tube measure pressure in the esophagus and reveal how well the muscles relax when you swallow. […] If you have repeated episodes of chest pain but your doctor has ruled out heart problems and GERD, talk to them about this condition. Esophageal spasms that come and go sometimes take years to diagnose.

• #64 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541106/

  Diffuse esophageal spasm is an esophageal motility disorder that often manifests as dysphagia. If the diagnosis is delayed, diffuse esophageal spasm is associated with high morbidity. […] Explain the techniques used to diagnose diffuse esophageal spasms. […] Evaluation of non-cardiac chest pain in older patients, males, white race, and those presenting with dysphagia are candidates for esophageal function testing. […] Twenty-four-hour manometry is the best modality to diagnose DES as a cause of noncardiac chest pain and should be combined with endoscopy and barium swallow to rule out any kind of inflammation and neoplasia in the esophagus. […] Although the diagnosis is usually made by means of esophageal manometry, tests like endoscopy and barium swallow are helpful in excluding inflammatory or neoplastic changes. […] The introduction of newer techniques like high-resolution manometry (HRM) and esophageal pressure topography (EPT) has significantly enhanced the ability to diagnose DES.

• #65 Diagnosing Esophageal Spasm: Tests and Procedures You Need to Know

  https://www.darwynhealth.com/digestive-disorders/digestive-disorders/esophageal-and-swallowing-disorders/esophageal-spasm/diagnosing-esophageal-spasm-tests-and-procedures-you-need-to-know/?lang=en

  In conclusion, early and accurate diagnosis of esophageal spasm is crucial for effective treatment. If you experience symptoms such as chest pain, difficulty swallowing, or heartburn, it is important to seek medical attention promptly. Diagnostic tests play a vital role in identifying the underlying cause of your symptoms and guiding appropriate treatment options.

• #66 Diffuse Esophageal Spasm – MD Searchlight

  https://mdsearchlight.com/gut-health/diffuse-esophageal-spasm/

  The tests needed for Diffuse Esophageal Spasm (DES) include: Twenty-four-hour manometry: This test is the most effective way to determine if the cause of chest pain is DES. […] Endoscopy: This test is used to check for any inflammation or abnormal growths in the esophagus. […] Barium swallow test: This test can confirm the cause of DES and check for any abnormal contractions. […] The prognosis for Diffuse Esophageal Spasm (DES) is generally moderate, with noticeable improvements in symptoms over a three-year period. […] While the risk of death from DES is low, it can significantly impact a patient’s quality of life and lead to other health complications.

• #67 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://www.wjgnet.com/2307-8960/full/v8/i6/1026.htm

  Another relatively new technologic tool is the functional lumen imaging probe (FLIP) which is increasingly being utilized as an additional diagnostic instrument in evaluating esophageal disorders. […] Although DES has been refined into a more homogenous disorder using specific criteria on HRM, its clinical presentation is heterogenous. The most common symptoms of DES include dysphagia (55%) followed by chest pain (29%). […] Findings on ancillary tests such as endoscopy and barium esophagram are not specific to DES, but they can provide important clues toward the diagnosis. […] The corkscrew appearance results from tertiary, non-propulsive contractions of the esophagus circular muscles. […] DES and spastic achalasia (achalasia type 3) appear to share a common pathophysiologic pathway. […] In cases with persistent symptoms despite medical therapy, endoscopic treatment interventions with botulinum toxin injection and Peroral endoscopic myotomy (POEM) should be considered.

• #68 A Case of Symptomatic Diffuse Esophageal Spasm During Multiple Rapid Swallowing Test on High-Resolution Manometry

  https://www.jnmjournal.org/journal/view.html?uid=297&vmd=Full

  Although many patients with non-obstructive dysphagia and chest pain can be diagnosed accurately by the conventional esophageal manometry, some patients go through difficulties in receiving proper diagnosis. […] The major advantage of HRM with pressure topography compared with conventional manometry is the ability to easily distinguish between the loci of compartmentalized intra-esophageal pressurization (pseudo-spasm) and rapidly propagated esophageal contractions (spasm). […] […] However, she had a PFV of more than 8 cm/s in more than 20% of their swallows and met the criteria for a rapidly propagated contraction. Therefore we could diagnose her case as DES. […] […] Several studies suggest that the motility disorders such as DES, nutcracker esophagus and achalasia share a common pathophysiologic mechanism, which involves the alteration in nitric oxide synthesis/degradation or loss of nitric oxide containing inhibitory neurons in the lower esophageal sphincter (LES). […] DES is associated with incomplete LES relaxation, which is likely in a variant case of achalasia. […]

• #69 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7103967/

  Distal esophageal spasm (DES) is diagnosed by finding of 20% premature contractions, with normal lower esophageal sphincter (LES) relaxation on high-resolution manometry (HRM) in the latest version of CCv3.0. […] Currently, the specific characteristics of DES on HRM are premature contractions ( 20% of wet swallows) and normal relaxation of lower esophageal sphincter (LES). […] HRM is the gold standard for the diagnosis of DES. The CC v3.0 classifies DES as a major motility disorder and defines DES by findings of premature contractions [distal latency (DL) 4.5 s] in at least 20% of wet swallows, in conjunction with normal LES relaxation measured by integrated relaxation pressure 15 mmHg. […] The previously used criteria of rapid contractions, defined as contractile front velocity greater than 9 cm/s, to diagnose DES was removed from the CC v3.0 as this was shown to be non-specific and can be seen in normal subjects and in other esophageal motility disorders.

• #70 Esophageal hypermotility disorders – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/esophageal-hypermotility-disorders/

  High-resolution esophageal manometry (HRM) is the gold standard for diagnosing esophageal motility disorders. […] Distal esophageal spasm is diagnosed by measuring the duration of latency periods. Hypercontractile esophagus and hypertensive peristalsis are diagnosed by measuring the strength of peristalsis.

• #71 Distal esophageal spasm: Update on diagnosis and management in the era of high-resolution manometry

  https://www.wjgnet.com/2307-8960/full/v8/i6/1026.htm

  Another relatively new technologic tool is the functional lumen imaging probe (FLIP) which is increasingly being utilized as an additional diagnostic instrument in evaluating esophageal disorders. […] Although DES has been refined into a more homogenous disorder using specific criteria on HRM, its clinical presentation is heterogenous. The most common symptoms of DES include dysphagia (55%) followed by chest pain (29%). […] Findings on ancillary tests such as endoscopy and barium esophagram are not specific to DES, but they can provide important clues toward the diagnosis. […] The corkscrew appearance results from tertiary, non-propulsive contractions of the esophagus circular muscles. […] DES and spastic achalasia (achalasia type 3) appear to share a common pathophysiologic pathway. […] In cases with persistent symptoms despite medical therapy, endoscopic treatment interventions with botulinum toxin injection and Peroral endoscopic myotomy (POEM) should be considered.

• #72 Esophageal Spasm Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/174975-workup

  Esophageal manometry and pH monitoring are crucial to distinguish between primary and secondary esophageal motility disorders and to guide appropriate therapy. […] Esophageal manometry may be combined with multichannel intraluminal impedance to obtain pressure and bolus transit information. […] Esophageal pH recording and 24-hour ambulatory manometry may improve the detection of esophageal muscle dysfunction.

• #73 To your good health: Painful esophageal spasm needs expert diagnosis

  https://www.staugustine.com/story/lifestyle/2014/05/08/your-good-health-painful-esophageal-spasm-needs-expert-diagnosis/16117993007/

  Diffuse esophageal spasm is an uncommon disorder in which the nerves and muscles of the esophagus act abnormally during swallowing and can cause chest pain, heartburn, regurgitation or difficulty swallowing. […] It can be hard to diagnose definitively, with the „gold standard” for diagnosis being manometry, a measurement of the nerve impulses and pressures inside the esophagus, sometimes with a medication injected to see if it causes spasm. […] I think your daughter really needs an expert in this disorder. Gastroenterologists, who are themselves subspecialists, are not always familiar with this condition, and it may require a gastroenterologist who subsubspecializes in swallowing problems to properly diagnose and help your daughter.

• #74 A Case of Symptomatic Diffuse Esophageal Spasm During Multiple Rapid Swallowing Test on High-Resolution Manometry

  https://www.jnmjournal.org/journal/view.html?uid=297&vmd=Full

  Recently, the development of high-resolution manometry (HRM) and topographical displays has yielded new perspectives and insights into esophageal motor functions. HRM helps to differentiate true esophageal spasm from rapid elevation of the intra-bolus pressure due to focal dysmotility or obstruction. Applying this distinction makes the diagnosis of DES very rare. […] […] We diagnosed a female patient with dysphagia and chest pain which were triggered by swallowing a large amount of water as DES on multiple rapid swallowing testing during HRM. […] […] HRM was performed to access the esophageal motility. […] We diagnosed her with DES because more than 20% of total swallows induced symptomatic esophageal spasms. […] […] This case was interesting in that the chest pain and dysphagia occurred not by drinking a sip of water, but only by drinking a large amount of water. […] Not only were we able to diagnose DES with accuracy, we were also able to observe the esophageal spasms developed with onset of symptoms through multiple rapid swallowing test without any other kind of provocation tests. […]

• #75 Diagnosing Esophageal Spasm: Tests and Procedures You Need to Know

  https://www.darwynhealth.com/digestive-disorders/digestive-disorders/esophageal-and-swallowing-disorders/esophageal-spasm/diagnosing-esophageal-spasm-tests-and-procedures-you-need-to-know/?lang=en

  In conclusion, early and accurate diagnosis of esophageal spasm is crucial for effective treatment. If you experience symptoms such as chest pain, difficulty swallowing, or heartburn, it is important to seek medical attention promptly. Diagnostic tests play a vital role in identifying the underlying cause of your symptoms and guiding appropriate treatment options.

• #76 Diffuse Esophageal Spasm – MD Searchlight

  https://mdsearchlight.com/gut-health/diffuse-esophageal-spasm/

  The tests needed for Diffuse Esophageal Spasm (DES) include: Twenty-four-hour manometry: This test is the most effective way to determine if the cause of chest pain is DES. […] Endoscopy: This test is used to check for any inflammation or abnormal growths in the esophagus. […] Barium swallow test: This test can confirm the cause of DES and check for any abnormal contractions. […] The prognosis for Diffuse Esophageal Spasm (DES) is generally moderate, with noticeable improvements in symptoms over a three-year period. […] While the risk of death from DES is low, it can significantly impact a patient’s quality of life and lead to other health complications.

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