DIFFUSE ESOPHAGEAL SPASM
DIFFUSE ESOPHAGEAL SPASM (DES)
- Repetitive, uncoordinated simultaneous contractions of oesophagus.
- It is manifested by episodes of dysphagia and chest pain with abnormal oesophageal contraction and normal deglutitive LOS relaxation.
Etiology-
- Unknown but stress may be etiology.
Pathogenesis-
- Motor abnormality of the lower third oesophageal body.
Clinical features-
- Hypertrophy of circular muscles
- Dysphagia
- Chest pain
Investigations-
- Barium swallow-
- Typically as corkscrew oesophagus
2. Manometry-
- It is the diagnostic test
3. Ambulatory 24hrs pH montoring-
- Important test to rule out GERD.
Treatment-
- Medical therapy
- Pneumatic dilatation intra-sphincteric
- Botulinum toxin injection
- Heller’s myotomy and
- Partial fundoplication.
Exam Important
- It is manifested by episodes of dysphagia and chest pain with abnormal oesophageal contraction and normal deglutitive LOS relaxation.
- Motor abnormality of the lower third oesophageal body.
Investigations-
- Barium swallow-
- Typically as corkscrew oesophagus
2. Manometry-
- It is the diagnostic test
3. Ambulatory 24hrs pH montoring-
- Important test to rule out GERD.
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