Materiały źródłowe

• #1 Esophageal spasms | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophageal-spasms

  Esophageal spasms are painful contractions in the muscular tube connecting the mouth and stomach, called the esophagus. […] 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.

• #1 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

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

  The etiology of diffuse esophageal spasm is unknown. There are various theories proposed. […] There is a disruption of coordination in peristalsis, which is probably due to an imbalance between the inhibitory and excitatory postganglionic pathways. Muscular hypertrophy or hyperplasia is present in the distal part of the esophagus, comprising almost two-thirds of the esophagus in DES. Although the triggering event is unknown, the Increased release of acetylcholine might be a factor. Other theories include nitric oxide-mediated impairment of inhibitory ganglion neuronal function, gastric reflux, or a primary nerve or motor disorder as likely mechanisms of the peristaltic abnormalities seen in DES. […] Exposure to acid can also result in esophageal spasms, whereas heartburn can lead to esophageal contractions. […] There have also been suggestions that total cholesterol and body mass index (BMI) are factors that have a high predictive value for esophageal contractility; at the same time, blood glucose and BMI are factors predictive for the function of the lower esophageal sphincter.

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

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

  Doctors are not sure what causes esophageal spasms, but it is known that they are a type of motility disorder. That means theres a problem with how the muscles in the food pipe squeeze together (contract) to move contents through the rest of the gastrointestinal (GI) system. Nerve signals from the brain tell the muscles in your esophagus to contract when you swallow something. Faulty nerve signaling may play a role in whether or not you develop this condition. […] There are two main types of esophagus spasms: […] Distal esophageal spasm (DES). These are uncoordinated spasms that often happen along with regurgitation. That means food and liquids come back up after you swallow them. […] Nutcracker or jackhammer esophagus. A twisted, or corkscrew-shaped, esophagus is often involved in powerful spasms. Regurgitation is not common with this type.

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

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

  Esophageal spasms happen when abnormal muscle contractions in your esophagus make it harder for food and liquids to reach your stomach. […] Medical experts don’t know the exact cause. But some believe spasms happen because of faulty nerves that control how your esophagus muscles work. […] In some instances, the faulty nerves may relate to excess acid in your esophagus. Many people with esophageal spasms also have chronic acid reflux (GERD). […] Recent research suggests that people who use opioids for three months or longer are more likely to develop esophageal spasms. […] More research is needed to determine the specific cause and risk factors.

• #1 What Are Esophageal Spasms? – Allied Digestive Health

  https://allieddigestivehealth.com/what-are-esophageal-spasms/

  Chest pain and dysphagia (difficulty in swallowing) account for a reasonable percentage of hospital consultations. In some patients, these occur due to a spasm of the esophagus, a muscular tube that moves food from the mouth to the stomach. […] Although the exact cause of esophageal spasm is not well established, several theories explain the initiating event: Uncoordinated brain signals, Primary motor nerve disorders, Increased release of neurotransmitter acetylcholine due to unknown mechanism, Gastroesophageal reflux disease: long-standing gastroesophageal can lead to spasms, especially when the esophagus is narrowing, High body mass index (BMI), Hyperglycemia, Diet: Some dietary factors leading to esophageal spasms include drinking red wine and consuming cold or hot foods or drinks, Hyperlipidemia: high levels of total cholesterol are associated with a high risk of esophageal spasms, Anxiety and depression, Treatment: some treatments such as surgery for the esophagus and radiation of the chest, neck, and head can lead to esophageal spasms.

• #1 Esophageal Spasm (Nutcracker Esophagus): What To Know

  https://www.health.com/esophageal-spasm-8667542

  An esophageal spasm occurs when the esophageal muscles contract abnormally. […] Determining the cause of esophageal spasms is critical for managing it. […] Researchers do not fully understand the causes of esophageal spasms. The current theories link the condition to irregular nerve activity in the esophageal muscles, exposure to stomach acids due to gastroesophageal reflux disease (GERD), and motor problems with the esophagus. […] Esophageal spasms occur when these nerves misfire and don’t work together. This causes a mismatch between the excitatory signals telling muscles to contract and the inhibitory ones, which relax them. […] Some researchers believe this constant exposure to stomach acids affects the esophageal muscle nerves, causing their patterns of activity to change and leading to esophageal spasms. […] Another potential cause of esophageal spasm is spastic achalasia, a rare motility disorder (trouble moving food through the body). […] While there’s still debate about the exact causes of esophageal spasms, researchers have identified potential triggers.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2352

  The cause of esophageal spasm is not known, although it is more common in people who have gastroesophageal reflux disease (GERD). […] In some people, very hot or very cold foods can trigger a spasm. […] Avoid very hot or cold foods if they trigger esophageal spasms.

• #1 Esophageal Spasms | Loma Linda University Health

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

  When the muscular tube that connects your mouth to your stomach (the esophagus) tightens or contracts abnormally, it is known as spasm. Esophageal spasms are not very common. […] Although the cause of esophageal spasms isnt clear, these spasms may be related to abnormal functioning of the nerves that control the muscles you use to swallow. […] Consuming very hot or very cold foods or drinks, or foods that are not chewed enough before swallowing may trigger a spasm. […] Sometimes, symptoms that may suggest esophageal spasm are the result of another condition such as gastroesophageal reflux disease (GERD) or achalasia. […] In addition, the risk of developing esophageal spasms seems to increase in people who have high blood pressure, anxiety or depression. Drinking red wine or consuming very hot or very cold foods or drinks also seems to increase the risk of developing esophageal spasms. […] Because esophageal spasms seem to be associated with gastroesophageal reflux (GERD) disease, those at risk for GERD may also be at greater risk of developing esophageal spasms.

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

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

  Esophageal spasms occur when the esophagus contracts abnormally, and they can be painful and uncomfortable. […] There is no definitive reason why esophageal spasms occur. It is thought that a problem with the nerves controlling the esophageal muscles may be one cause. […] Many people find that there are specific triggers that prompt esophageal spasms. These include: food and drink, such as red wine or spicy food; temperature of food, being either too hot or too cold; medication and treatment for cancer, including radiation or surgery on the esophagus; stress, depression, or anxiety; gastroesophageal reflux disease (GERD), if scarring or narrowing of the esophagus occurs. […] While esophageal spasms are rare, there are certain risk factors which may make a person more susceptible to them. […] An underlying condition, such as GERD or depression, may be the cause of esophageal spasms, in which case these should be treated to relieve symptoms.

• #1 Diffuse esophageal spasm – Wikipedia

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

  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 (dysphagia) or regurgitation. […] In many cases, the cause of DES remains unknown. […] The causes of diffuse esophageal spasm is unclear. It is thought, however, that many cases are caused by uncontrolled brain signals running to nerve endings. […] Food allergies or intolerances may also be a cause in which spasms may be triggered within hours or days from the offending foods.

• #1 Cary Gastroenterology Associates | Tied in Knots: Esophageal Spasm…

  https://www.carygastro.com/blog/tied-in-knots-esophageal-spasm-explained

  Esophageal spasm is the unexpected, uncoordinated contraction of your esophageal muscles. […] An esophageal spasm occurs when one of a set of triggers causes the muscles in your esophagus to contract when they are not supposed to. […] We do not yet fully understand what causes esophageal spasms. There are a set of underlying conditions that make you predisposed to having a spasm, but the exact reasons may not be immediately obvious. […] Food triggers can be the cause of esophageal spasm for many people. This can either be linked to a particular type of food, but is more commonly associated with eating hot or cold foods. […] There are several other factors that are strongly correlated to the presence of esophageal spasms, but the exact causal links are not well understood. A few of these risk factors include: being between 60-80 years old, high blood pressure, anxiety or depression, gastroesophageal reflux disease (GERD), consumption of red wine.

• #1 Esophageal spasms – Hancock Health

  https://www.hancockhealth.org/es/mayo-health-library/esophageal-spasms/

  Esophageal spasms are painful contractions in the muscular tube connecting the mouth and stomach, called the esophagus. […] Its 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.

• #1 Esophageal Spasm: Symptoms, Causes and Treatment

  https://www.medicoverhospitals.in/diseases/esophageal-spasm/

  Esophageal spasm is a condition where the muscles in the esophagus, the tube that carries food from the mouth to the stomach, contract abnormally. […] While the exact cause of esophageal spasm is not fully understood, it is believed to be related to problems with the nerves that control the muscles in the esophagus. […] Factors such as acid reflux, stress, and certain foods may trigger esophageal spasms in some individuals. […] Esophageal spasm, a condition characterized by abnormal contractions of the esophagus, can have various causes. […] Gastroesophageal reflux disease (GERD) can cause esophageal spasm due to stomach acid irritating the esophagus lining. […] Anxiety and stress may trigger esophageal spasms by affecting the normal functioning of the esophageal muscles. […] Certain medications, such as bisphosphonates used for osteoporosis treatment, can lead to esophageal spasms as a side effect. […] Nutritional deficiencies, particularly in magnesium, can contribute to esophageal spasms by impacting muscle function and nerve signaling. […] Infections like candidiasis or herpes can cause inflammation in the esophagus, potentially leading to spasms as a response to the irritation.

• #1 Distal Esophageal Spasm: An Updated Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10404380/

  Distal esophageal spasm (DES) is an idiopathic motility disorder of the esophagus that can cause significant discomfort and impairment of quality of life in affected individuals. […] The condition is characterized by abnormal smooth muscle contractions in the distal esophagus, leading to symptoms such as dysphagia, chest pain, and regurgitation. […] DES involves abnormal coordination within the smooth muscles of the esophagus, likely stemming from an imbalance between the nitrogenic inhibitory and cholinergic excitatory pathways. […] It has been hypothesized that a reduction in this interval could potentially lead to premature and rapidly propagating contractions in DES. […] A major point of focus has been nitric oxide (NO) due to its role in the inhibitory pathway of the myenteric plexus.

• #1 Esophageal Spasm: Background, Pathophysiology, Epidemiology

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

  Broadly, esophageal spasm can be divided into two major variants that are distinct entities: (1) diffuse esophageal spasm and (2) hypertensive peristalsis. […] The etiology of esophageal spasm is unknown. Increased release of acetylcholine appears to be a factor (sensitive to cholinergic stimulation), but the triggering event is not known. Other theories include gastric reflux or a primary nerve or motor disorder. […] Research is ongoing to determine the underlying causes to improve diagnostic capabilities and therapeutic regimens in the future. […] Nutcracker and jackhammer esophagus occur when the amplitude of the contractions exceed 2 standard deviations from normal. […] The symptoms of diffuse esophageal spasm, nutcracker esophagus, and jackhammer esophagus may overlap and can be distinguished only by a motility study.

• #1 Diffuse Esophageal Spasm | Cedars-Sinai

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

  Diffuse esophageal spasms can be caused by disruptions or damage to the nerves that coordinate the muscles of the esophagus. […] In some cases, this condition can lead to achalasia.

• #1 Distal Esophageal Spasm: An Updated Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10404380/

  Opioids, which have been associated with DES, increase NO secretion and inhibit neuronal excitation. […] Gastroesophageal reflux disease (GERD) might also be related to DES. […] It is believed that exposure to stomach acidity may modify the afferent nerves of the peristaltic peripheral pathways and thus lead to DES, however, this relationship is debatable. […] Spastic achalasia is another disorder believed to be pathophysiologically related to DES. […] The course of DES appears to be benign without an increased risk for mortality or carcinoma development. […] The disease however did show a potential to progress to achalasia type 3 and esophageal diverticula.

• #1 5 Facts about Esophageal Cancer You Should Know – NFCR

  https://www.nfcr.org/blog/5-facts-about-esophageal-cancer/

  Esophageal spasms are not linked to cancer. […] Though not linked to cancer, they can cause other health complications.

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

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

  Esophageal spasms happen when abnormal muscle contractions in your esophagus make it harder for food and liquids to reach your stomach. […] Medical experts don’t know the exact cause. But some believe spasms happen because of faulty nerves that control how your esophagus muscles work. […] In some instances, the faulty nerves may relate to excess acid in your esophagus. Many people with esophageal spasms also have chronic acid reflux (GERD). […] Recent research suggests that people who use opioids for three months or longer are more likely to develop esophageal spasms. […] More research is needed to determine the specific cause and risk factors.

• #2 Esophageal spasms

  https://www.mymlc.com/health-information/diseases-and-conditions/e/esophageal-spasms2/

  Esophageal spasms are painful contractions within the muscular tube connecting your mouth and stomach (esophagus). […] It’s not clear what causes esophageal spasms. However, they appear to be related to abnormal functioning of nerves that control the muscles you use when you swallow. […] Esophageal spasms make it difficult for the muscles in the walls of your lower esophagus to coordinate in order to move food to your stomach. […] There are two types of esophageal spasms — distal esophageal spasm and hypercontractile esophagus, also referred to as jackhammer esophagus.

• #2 Diffuse Esophageal Spasm (DES) – Esophageal Health | UCLA Health

  https://www.uclahealth.org/medical-services/gastro/esophageal-health/diseases-we-treat/diffuse-esophageal-spasm-des

  The cause is unknown, but studies have suggested that it involves impaired nervous system input to the esophagus, using a neurotransmitter called nitric oxide (NO). […] Gastroesophageal reflux disease (GERD) might also be involved in a fraction of cases.

• #2 Esophageal Spasm: Background, Pathophysiology, Epidemiology

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

  Broadly, esophageal spasm can be divided into two major variants that are distinct entities: (1) diffuse esophageal spasm and (2) hypertensive peristalsis. […] The etiology of esophageal spasm is unknown. Increased release of acetylcholine appears to be a factor (sensitive to cholinergic stimulation), but the triggering event is not known. Other theories include gastric reflux or a primary nerve or motor disorder. […] Research is ongoing to determine the underlying causes to improve diagnostic capabilities and therapeutic regimens in the future. […] Nutcracker and jackhammer esophagus occur when the amplitude of the contractions exceed 2 standard deviations from normal. […] The symptoms of diffuse esophageal spasm, nutcracker esophagus, and jackhammer esophagus may overlap and can be distinguished only by a motility study.

• #2 Distal Esophageal Spasm: An Updated Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10404380/

  Distal esophageal spasm (DES) is an idiopathic motility disorder of the esophagus that can cause significant discomfort and impairment of quality of life in affected individuals. […] The condition is characterized by abnormal smooth muscle contractions in the distal esophagus, leading to symptoms such as dysphagia, chest pain, and regurgitation. […] DES involves abnormal coordination within the smooth muscles of the esophagus, likely stemming from an imbalance between the nitrogenic inhibitory and cholinergic excitatory pathways. […] It has been hypothesized that a reduction in this interval could potentially lead to premature and rapidly propagating contractions in DES. […] A major point of focus has been nitric oxide (NO) due to its role in the inhibitory pathway of the myenteric plexus.

• #2 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

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

  The etiology of diffuse esophageal spasm is unknown. There are various theories proposed. […] There is a disruption of coordination in peristalsis, which is probably due to an imbalance between the inhibitory and excitatory postganglionic pathways. Muscular hypertrophy or hyperplasia is present in the distal part of the esophagus, comprising almost two-thirds of the esophagus in DES. Although the triggering event is unknown, the Increased release of acetylcholine might be a factor. Other theories include nitric oxide-mediated impairment of inhibitory ganglion neuronal function, gastric reflux, or a primary nerve or motor disorder as likely mechanisms of the peristaltic abnormalities seen in DES. […] Exposure to acid can also result in esophageal spasms, whereas heartburn can lead to esophageal contractions. […] There have also been suggestions that total cholesterol and body mass index (BMI) are factors that have a high predictive value for esophageal contractility; at the same time, blood glucose and BMI are factors predictive for the function of the lower esophageal sphincter.

• #2 Distal Esophageal Spasm: An Updated Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10404380/

  Opioids, which have been associated with DES, increase NO secretion and inhibit neuronal excitation. […] Gastroesophageal reflux disease (GERD) might also be related to DES. […] It is believed that exposure to stomach acidity may modify the afferent nerves of the peristaltic peripheral pathways and thus lead to DES, however, this relationship is debatable. […] Spastic achalasia is another disorder believed to be pathophysiologically related to DES. […] The course of DES appears to be benign without an increased risk for mortality or carcinoma development. […] The disease however did show a potential to progress to achalasia type 3 and esophageal diverticula.

• #2 Esophageal Spasms | Loma Linda University Health

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

  When the muscular tube that connects your mouth to your stomach (the esophagus) tightens or contracts abnormally, it is known as spasm. Esophageal spasms are not very common. […] Although the cause of esophageal spasms isnt clear, these spasms may be related to abnormal functioning of the nerves that control the muscles you use to swallow. […] Consuming very hot or very cold foods or drinks, or foods that are not chewed enough before swallowing may trigger a spasm. […] Sometimes, symptoms that may suggest esophageal spasm are the result of another condition such as gastroesophageal reflux disease (GERD) or achalasia. […] In addition, the risk of developing esophageal spasms seems to increase in people who have high blood pressure, anxiety or depression. Drinking red wine or consuming very hot or very cold foods or drinks also seems to increase the risk of developing esophageal spasms. […] Because esophageal spasms seem to be associated with gastroesophageal reflux (GERD) disease, those at risk for GERD may also be at greater risk of developing esophageal spasms.

• #2 What Are Esophageal Spasms? – Allied Digestive Health

  https://allieddigestivehealth.com/what-are-esophageal-spasms/

  Chest pain and dysphagia (difficulty in swallowing) account for a reasonable percentage of hospital consultations. In some patients, these occur due to a spasm of the esophagus, a muscular tube that moves food from the mouth to the stomach. […] Although the exact cause of esophageal spasm is not well established, several theories explain the initiating event: Uncoordinated brain signals, Primary motor nerve disorders, Increased release of neurotransmitter acetylcholine due to unknown mechanism, Gastroesophageal reflux disease: long-standing gastroesophageal can lead to spasms, especially when the esophagus is narrowing, High body mass index (BMI), Hyperglycemia, Diet: Some dietary factors leading to esophageal spasms include drinking red wine and consuming cold or hot foods or drinks, Hyperlipidemia: high levels of total cholesterol are associated with a high risk of esophageal spasms, Anxiety and depression, Treatment: some treatments such as surgery for the esophagus and radiation of the chest, neck, and head can lead to esophageal spasms.

• #2 Esophageal Spasms And Anxiety – AnxietyCentre.com

  https://www.anxietycentre.com/anxiety-disorders/symptoms/esophageal-spasms-anxiety/

  Esophageal spasms are sudden muscle contractions (spasms) in the esophagus, which is the tube linking your throat to your stomach. […] Some anxious people get esophageal spasms due to acute stress, such as from acute anxiety. […] Anxiety and depression are common causes of esophageal spasms. […] Excess stomach acid and reflux can also cause the esophagus to spasm for some people. […] Esophageal spasms are a common indication of hyperstimulation (chronic stress) for some people.

• #2 Esophageal spasms – Hancock Health

  https://www.hancockhealth.org/es/mayo-health-library/esophageal-spasms/

  Esophageal spasms are painful contractions in the muscular tube connecting the mouth and stomach, called the esophagus. […] Its 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 What Is Nutcracker Esophagus (Hypertensive Peristalsis)?

  https://www.verywellhealth.com/nutcracker-esophagus-hypertensive-peristalsis-4158668

  Esophageal spasms may be more common in Caucasian people and occur more frequently in women than men. […] It is not known exactly what causes nutcracker esophagus. Some theories are that the condition is closely related to gastroesophageal reflux disorder (GERD) and may be caused by it. Another theory is that it is caused by a nerve disorder, and some people believe it is caused by an abnormal response to the substance acetylcholine. […] Several medications are used to treat this condition and include calcium channel blockers, nitrates, and phosphodiesterase inhibitors. Injections of botulinum toxin above the lower esophageal sphincter can temporarily relieve symptoms by blocking the release of acetylcholine. […] In extreme cases that haven’t responded well to other treatment, a surgical procedure called a myotomy may be warranted. This procedure is also called a Heller myotomy or esophageal myotomy and is most often used to treat achalasia but can be used to treat nutcracker esophagus as well.

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

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

  Esophageal spasms occur when the esophagus contracts abnormally, and they can be painful and uncomfortable. […] There is no definitive reason why esophageal spasms occur. It is thought that a problem with the nerves controlling the esophageal muscles may be one cause. […] Many people find that there are specific triggers that prompt esophageal spasms. These include: food and drink, such as red wine or spicy food; temperature of food, being either too hot or too cold; medication and treatment for cancer, including radiation or surgery on the esophagus; stress, depression, or anxiety; gastroesophageal reflux disease (GERD), if scarring or narrowing of the esophagus occurs. […] While esophageal spasms are rare, there are certain risk factors which may make a person more susceptible to them. […] An underlying condition, such as GERD or depression, may be the cause of esophageal spasms, in which case these should be treated to relieve symptoms.

• #2 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

  Dysphagia and chest pain are commonly encountered problems in gastroenterology. Spasm of esophagus is often suggested as the cause of unexplained chest pain or dysphagia. Once cardiovascular disease and structural disease have been excluded, esophageal manometry should be performed to detect motility disorders as the cause of symptoms.1 […] Diffuse esophageal spasm (DES) is an uncommon motility disorder of unknown etiology in which has been offered as a possible cause for the patient’s dysphagia or chest pain. Manometric evaluation of the esophagus is considered to be the gold standard in patients suspected with DES.1 The most accepted diagnostic criteria for DES is the presence of simultaneous contractions in at least 20% of wet swallows, intermixed with normal peristaltic sequences.2 […] 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). The loss of intramural inhibitory neurons leads to the loss of normal peristalsis and inability of the LES to relax properly during swallowing.7-10 DES is associated with incomplete LES relaxation, which is likely in a variant case of achalasia.2 The fact that the transition from DES to achalasia has been documented and is believed to occur in 3% to 5% of patients supports this observation.11,12 […]

• #2 Esophageal Spasm (Nutcracker Esophagus): What To Know

  https://www.health.com/esophageal-spasm-8667542

  An esophageal spasm occurs when the esophageal muscles contract abnormally. […] Determining the cause of esophageal spasms is critical for managing it. […] Researchers do not fully understand the causes of esophageal spasms. The current theories link the condition to irregular nerve activity in the esophageal muscles, exposure to stomach acids due to gastroesophageal reflux disease (GERD), and motor problems with the esophagus. […] Esophageal spasms occur when these nerves misfire and don’t work together. This causes a mismatch between the excitatory signals telling muscles to contract and the inhibitory ones, which relax them. […] Some researchers believe this constant exposure to stomach acids affects the esophageal muscle nerves, causing their patterns of activity to change and leading to esophageal spasms. […] Another potential cause of esophageal spasm is spastic achalasia, a rare motility disorder (trouble moving food through the body). […] While there’s still debate about the exact causes of esophageal spasms, researchers have identified potential triggers.

• #2 Esophageal Spasm

  https://www.myactivehealth.com/hwcontent/content/special/ut1638spec.html

  Esophageal spasm means that contractions of the esophagus are irregular, uncoordinated, and sometimes powerful. […] The cause of esophageal spasm is unknown. Many doctors believe it results from a disruption of the nerve activity that coordinates the swallowing action of the esophagus. […] In some people, very hot or very cold foods may trigger an episode.

• #3 Diffuse Esophageal Spasm – StatPearls – NCBI Bookshelf

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

  The etiology of diffuse esophageal spasm is unknown. There are various theories proposed. […] There is a disruption of coordination in peristalsis, which is probably due to an imbalance between the inhibitory and excitatory postganglionic pathways. Muscular hypertrophy or hyperplasia is present in the distal part of the esophagus, comprising almost two-thirds of the esophagus in DES. Although the triggering event is unknown, the Increased release of acetylcholine might be a factor. Other theories include nitric oxide-mediated impairment of inhibitory ganglion neuronal function, gastric reflux, or a primary nerve or motor disorder as likely mechanisms of the peristaltic abnormalities seen in DES. […] Exposure to acid can also result in esophageal spasms, whereas heartburn can lead to esophageal contractions. […] There have also been suggestions that total cholesterol and body mass index (BMI) are factors that have a high predictive value for esophageal contractility; at the same time, blood glucose and BMI are factors predictive for the function of the lower esophageal sphincter.

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