Distal esophageal spasm.
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Distal esophageal spasm (formerly known as diffuse esophageal spasm) affects only the smooth-muscle portion of the esophagus. It is diagnosed on esophageal manometry by the presence of simultaneous, nonperistaltic esophageal contractions in 20% or more of wet swallows. Treatment recommendations, which are based only on small studies, include proton-pump inhibitors, nitrates, tricyclic anti-depressants, calcium channel blockers, and serotonin reuptake inhibitors. Distal esophageal spasm may also respond to botulinum toxin injections, dilation, or myotomy.
Sperandio M, Tutuian R, Gideon RM, et al. Diffuse esophageal spasm: Not diffuse but distal esophageal spasm (DES). Dig Dis Sci 2003;48(7):1380-4.
Tutuian R, Castell DO. Esophageal motility disorders (distal esophageal spasm, nutcracker esophagus, and hypertensive lower esophageal sphincter): Modern management. Curr Treat Options Gastroenterol 2006;9(4):283-94.
From the Center for Voice and Swallowing, University of California-Davis, Sacramento.
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|Title Annotation:||DYSPHAGIA CLINIC|
|Author:||Belafsky, Peter C.|
|Publication:||Ear, Nose and Throat Journal|
|Date:||Jun 1, 2007|
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