diffuse esophageal spasm


Summary: A hypermotility disorder of the ESOPHAGUS that is characterized by spastic non-peristaltic responses to SWALLOWING; CHEST PAIN; and DYSPHAGIA.

Top Publications

  1. Almansa C, Achem S. [Diffuse esophageal spasm (DES). Practical concepts of diagnosis and treatment]. Rev Gastroenterol Mex. 2007;72:136-45 pubmed
    b>Diffuse esophageal spasm (DES) is a motility disorder of undetermined etiology, typically presenting with chest pain, dysphagia or both...
  2. Iqbal A, Tierney B, Haider M, Salinas V, Karu A, Turaga K, et al. Laparoscopic re-operation for failed Heller myotomy. Dis Esophagus. 2006;19:193-9 pubmed
    ..Prior endoscopic therapies (pneumatic dilation or Botulinum toxin) were not associated with poor results. Laparoscopic re-operation for failed Heller myotomy is feasible and results are encouraging. ..
  3. Prabhakar A, Levine M, Rubesin S, Laufer I, Katzka D. Relationship between diffuse esophageal spasm and lower esophageal sphincter dysfunction on barium studies and manometry in 14 patients. AJR Am J Roentgenol. 2004;183:409-13 pubmed
    ..characteristics of the lower esophageal sphincter in a series of patients with radiographically defined diffuse esophageal spasm. In reviewing records in the radiology database at our hospital, we identified 14 patients with diffuse ..
  4. Kuwano H, Miyazaki T, Masuda N, Kato H, Kusano M. Long myotomy of the esophagus and gastric cardia with a complete fundic patch procedure for diffuse esophageal spasm. Hepatogastroenterology. 2004;51:1729-31 pubmed
    Under the hypothesis that the surgical management of diffuse esophageal spasm requires the elimination or reduction of episodes of dysphagia and chest pain and prevention of postoperative gastroesophageal reflux, long esophageal myotomy ..
  5. Fass R. Evaluation and diagnosis of noncardiac chest pain. Dis Mon. 2008;54:627-41 pubmed publisher
  6. Tutuian R, Mainie I, Agrawal A, Gideon R, Katz P, Castell D. Symptom and function heterogenicity among patients with distal esophageal spasm: studies using combined impedance-manometry. Am J Gastroenterol. 2006;101:464-9 pubmed
    ..Outcomes data are warranted to evaluate whether stratifying DES patients based on pressure and bolus transit information may improve the clinical approach. ..
  7. Griniatsos J, Vlavianos P, Karvounis E, Isla A. Diffuse oesophageal spasm masking achalasia. Int Surg. 2004;89:32-4 pubmed
    ..A 41-year-old female patient underwent thoracoscopic esophagomyotomy for diffuse esophageal spasm (DOS) with normal resting pressure and complete relaxation of the LOS; findings were confirmed in two ..
  8. Fox M, Sweis R, Wong T, Anggiansah A. Sildenafil relieves symptoms and normalizes motility in patients with oesophageal spasm: a report of two cases. Neurogastroenterol Motil. 2007;19:798-803 pubmed
    ..i.d. without troublesome side effects. This report shows that sildenafil can improve oesophageal function and relieve dysphagia and chest pain in patients with oesophageal spasm in whom other treatments have failed. ..
  9. Pimentel M, Bonorris G, Chow E, Lin H. Peppermint oil improves the manometric findings in diffuse esophageal spasm. J Clin Gastroenterol. 2001;33:27-31 pubmed
    b>Diffuse esophageal spasm (DES) is an uncommon condition that results in simultaneous esophageal contractions. Current medical treatment of DES is frequently unsatisfactory...

More Information


  1. Carniel E, Frigo A, Costantini M, Giuliani T, Nicoletti L, Merigliano S, et al. A physiological model for the investigation of esophageal motility in healthy and pathologic conditions. Proc Inst Mech Eng H. 2016;: pubmed
  2. Okamura S, Oshimoto H, Sakamoto T, Kusano M, Sekiguchi T, Mori M. Beta-adrenoreceptor agonists for diffuse esophageal spasm. J Gastroenterol. 2002;37:229-30 pubmed
  3. Carmona Sánchez R. [Diffuse esophageal spasm with atypical radiography]. Rev Gastroenterol Mex. 2004;69:110 pubmed
  4. Storr M, Linke R, Nicolaus M, Goke B, Schirra J. [Injection of botulinum toxin for diffuse esophageal spasm]. Dtsch Med Wochenschr. 2005;130:266-9 pubmed
    ..The diagnosis of diffuse esophageal spasm was confirmed by esophageal manometry and radiology...
  5. Almansa C, Hinder R, Smith C, Achem S. A comprehensive appraisal of the surgical treatment of diffuse esophageal spasm. J Gastrointest Surg. 2008;12:1133-45 pubmed
    b>Diffuse esophageal spasm is a motility disorder of undetermined cause. The optimal treatment remains controversial, and evidence-based data are lacking...
  6. Schneider J, Brücher B, Küper M, Saemann K, Konigsrainer A, Schneider J. Multichannel intraluminal impedance measurement of gastroesophageal reflux in patients with different stages of morbid obesity. Obes Surg. 2009;19:1522-9 pubmed publisher
    ..However, there is no evidence of a direct correlation between the severity of reflux and the extent of obesity. ..
  7. Tutuian R, Castell D. Review article: oesophageal spasm - diagnosis and management. Aliment Pharmacol Ther. 2006;23:1393-402 pubmed
    ..Botulinium toxin injections should be reserved for patients who do not respond. Pneumatic dilatations or myotomies represent rather heroic approaches for non-responding patients. ..
  8. Ramachandran K, Arunachalam P, Hurren A, Marsh R, Samuel P. Botulinum toxin injection for failed tracheo-oesophageal voice in laryngectomees: the Sunderland experience. J Laryngol Otol. 2003;117:544-8 pubmed
    ..Out of the three patients who were treated for hypertonic voice, two did derive some benefit from the procedure. One patient developed a hypotonic voice, which lasted for a few months. ..
  9. Turcu A, Berthet F, Leveque L, Besancenot J. [Complete dysphagia during paroxysmal atrial fibrillation]. Presse Med. 2002;31:935 pubmed
  10. Spechler S, Castell D. Classification of oesophageal motility abnormalities. Gut. 2001;49:145-51 pubmed
    ..This should facilitate and improve comparisons among patients and studies. However, it is important to emphasise that fulfilment of the proposed criteria does not establish the clinical importance of the motility abnormalities. ..
  11. Martínek J, Akiyama J, Vacková Z, Furnari M, Savarino E, Weijs T, et al. Current treatment options for esophageal diseases. Ann N Y Acad Sci. 2016;1381:139-151 pubmed publisher
    ..A system for defining and recording perioperative complications associated with esophagectomy has been recently developed and may help to find predictors of mortality and morbidity. ..
  12. Heatley M, Rose K, Weston C. The heart and the oesophagus: intimate relations. Postgrad Med J. 2005;81:515-8 pubmed
    ..Rather than proceed with investigations, in the absence of symptoms to suggest structural disease of the oesophagus, it would be reasonable to attempt symptomatic treatment with a proton pump inhibitor or an antidepressant. ..
  13. Su A, Gandhy R, Barlow C, Triadafilopoulos G. Clinical and manometric characteristics of patients with Parkinson's disease and esophageal symptoms. Dis Esophagus. 2017;30:1-6 pubmed publisher
    ..hierarchy of the Chicago classification, 12 patients (39%) exhibited EGJ outflow obstruction, 16 (48%) diffuse esophageal spasm (DES), 18 (55%), ineffective esophageal peristalsis (IEM), 16 (48%) fragmented peristalsis, and only 2 ..
  14. Usai Satta P, Oppia F, Piras R, Loriga F. Extrinsic autonomic neuropathy in a case of transition from diffuse esophageal spasm to achalasia. Clin Auton Res. 2004;14:270-2 pubmed
  15. Khan M, Kumbhari V, Ngamruengphong S, Ismail A, Chen Y, Chavez Y, et al. Is POEM the Answer for Management of Spastic Esophageal Disorders? A Systematic Review and Meta-Analysis. Dig Dis Sci. 2017;62:35-44 pubmed publisher
    Spastic esophageal disorders (SEDs) include spastic achalasia (type III), diffuse esophageal spasm (DES), and nutcracker/jackhammer esophagus (JH)...
  16. Koppman J, Poggi L, Szomstein S, Ukleja A, Botoman A, Rosenthal R. Esophageal motility disorders in the morbidly obese population. Surg Endosc. 2007;21:761-4 pubmed
    ..hypertensive LES pressure (>35 mmHg) (3%), isolated hypotensive LES pressure (<12 mmHg) (3%), diffuse esophageal spasm (1%), and achalasia (1%)...
  17. Weusten B, Smout A. Primary oesophageal motility disorders: how primary are they?. Eur J Gastroenterol Hepatol. 1999;11:1345-7 pubmed
    ..This article focuses on the pathophysiology of achalasia and nutcracker oesophagus. There is evidence that achalasia and nutcracker oesophagus should not be considered parts of one and the same range of diseases. ..
  18. Sáenz Félix V, Galindo Vázquez G. [Dysphagia: surgical options]. Rev Gastroenterol Mex. 2007;72 Suppl 2:45-8 pubmed
  19. Storr M. Letter 1: Functional results after extended myotomy for diffuse oesophageal spasm (Br J Surg 2007; 94: 1113-1118). Br J Surg. 2008;95:125; author reply 125 pubmed
  20. Morimoto N, Takahashi S, Inaba T, Takamiya M, Kageyama Y, Morimoto M, et al. A case of seropositive autoimmune autonomic ganglionopathy with diffuse esophageal spasm. J Clin Neurosci. 2017;39:90-92 pubmed publisher
    ..b>Diffuse esophageal spasm (DES) is an uncommon esophageal motility disorder...
  21. Dheer S, Chang R. Images in clinical medicine. "Corkscrew" esophagus. N Engl J Med. 2003;348:1671 pubmed
  22. Adler D, Romero Y. Primary esophageal motility disorders. Mayo Clin Proc. 2001;76:195-200 pubmed
    ..Spastic disorders of the esophagus, such as diffuse esophageal spasm and nutcracker esophagus, and nonspecific esophageal motility disorder are benign and nonprogressive, ..
  23. Khashab M, Benias P, Swanstrom L. Endoscopic Myotomy for Foregut Motility Disorders. Gastroenterology. 2018;154:1901-1910 pubmed publisher
    ..POEM also seems to be effective in the treatment of spastic esophageal disorders (eg, jackhammer and diffuse esophageal spasm)...
  24. Chao S, Graham S, Hoffman H. Management of pharyngoesophageal spasm with Botox. Otolaryngol Clin North Am. 2004;37:559-66 pubmed
    ..This article reviews the technique, results,and complications regarding the use of Botox in the management of TE speech failure associated with pharyngoesophageal spasm. ..
  25. Bajaj J, Shaker R, Hogan W. Esophageal veggie spasms: a food-specific cause of chest distress. Am J Gastroenterol. 2004;99:1396-8 pubmed
  26. Robertson A, Sultan J, Hayes N, Karat D, Griffin S. Letter 2: Functional results after extended myotomy for diffuse oesophageal spasm (Br J Surg 2007; 94: 1113-1118). Br J Surg. 2008;95:125-6; author reply 126 pubmed
  27. Nastos D, Chen L, Ferraro P, Taillefer R, Duranceau A. Long myotomy with antireflux repair for esophageal spastic disorders. J Gastrointest Surg. 2002;6:713-22 pubmed
    ..Patients with spastic disorders plus a diverticulum showed better clinical results and improved esophageal function after surgery when compared to patients with pure spastic disorders. ..
  28. Kato T, Naiki T, Araki H, Nagaki M, Moriwaki H. Diffuse esophageal spasm. Gastrointest Endosc. 2004;60:428 pubmed
  29. Kostic S, Lönroth H, Lundell L. Leakage testing at the time of surgical oesophageal myotomy. Dig Surg. 2004;21:223-6 pubmed
    ..Perioperative use of endoscopy at the time of completion of the surgical myotomy is a useful tool to document leakage. Thereby the safety profile of the operation can be further enhanced. ..
  30. Misra A, Chourasia D, Ghoshal U. Manometric and symptomatic spectrum of motor dysphagia in a tertiary referral center in northern India. Indian J Gastroenterol. 2010;29:12-6 pubmed publisher
    ..We studied the spectrum of motor dysphagia in a northern Indian tertiary referral center...
  31. Kahrilas P, Ergun G. Esophageal dysphagia. Acta Otorhinolaryngol Belg. 1994;48:171-90 pubmed
    ..Emphasis is placed on the dual sphincter theory of gastroesophageal junction competence and the need for maintenance anti-secretory therapy. ..
  32. Goyal O, Bansal M, Sood A. Esophageal motility disorders-Symptomatic and manometric spectrum in Punjab, northern India. Indian J Gastroenterol. 2017;36:202-208 pubmed publisher
    ..This study highlights the high prevalence of IEM among patients with esophageal symptoms, which can present with dysphagia or retrosternal discomfort due to poor bolus transit. ..
  33. Aziz Q, Fass R, Gyawali C, Miwa H, Pandolfino J, Zerbib F. Functional Esophageal Disorders. Gastroenterology. 2016;: pubmed publisher
    ..Future research needs to focus on understanding mechanisms underlying visceral hypersensitivity and hypervigilance so that appropriate targets and therapies can be developed. ..
  34. Grübel C, Borovicka J, Schwizer W, Fox M, Hebbard G. Diffuse esophageal spasm. Am J Gastroenterol. 2008;103:450-7 pubmed
    ..article is to review the clinical features, pathophysiology, diagnosis, and management of patients with diffuse esophageal spasm (DES)...
  35. Otani K, Tanaka S, Kawara F, Fujikawa J, Sawada A, Uemura R, et al. Distal esophageal spasm with multiple esophageal diverticula successfully treated by peroral endoscopic myotomy. Clin J Gastroenterol. 2017;10:442-446 pubmed publisher
    ..POEM could be a new curative strategy for the most severe DES cases with multiple diverticula. ..
  36. Bechara R, Inoue H. POEM, the Prototypical "New NOTES" Procedure and First Successful NOTES Procedure. Gastrointest Endosc Clin N Am. 2016;26:237-255 pubmed publisher
    ..POEM is also being used to successfully treat diffuse esophageal spasm (DES) and jackhammer esophagus...
  37. Goldberg M, Levine M, Torigian D. Diffuse esophageal spasm: CT findings in seven patients. AJR Am J Roentgenol. 2008;191:758-63 pubmed publisher
    ..and appearance of esophageal wall thickening on CT scans in a series of patients with findings of diffuse esophageal spasm on barium studies...
  38. Khatami S, Khandwala F, Shay S, Vaezi M. Does diffuse esophageal spasm progress to achalasia? A prospective cohort study. Dig Dis Sci. 2005;50:1605-10 pubmed
    b>Diffuse esophageal spasm (DES) and achalasia share both clinical and manometric characteristics. Some reports support the notion of progression of DES to achalasia...
  39. Raptis C, Levine M, Rubesin S, Laufer I, Katzka D. Transient failure of opening of the lower oesophageal sphincter on upright oesophagrams: radiographic and clinical findings. Br J Radiol. 2005;78:411-5 pubmed
    ..It is important to be aware of this finding, so that it is not mistaken for achalasia or other abnormalities of the distal oesophagus. ..
  40. Chone C, Seixas V, Paes L, Gripp F, Teixeira C, Andreollo N, et al. Use of computerized manometry for the detection of pharyngoesophageal spasm in tracheoesophageal speech. Otolaryngol Head Neck Surg. 2008;139:449-52 pubmed publisher
    ..CM is a clinically useful tool to aid in speech rehabilitation for tracheoesophageal speakers. Intraluminal pressures of greater than 16 mmHg was highly predictive for PES spasm. ..
  41. Castell J, Johnston B, Colcher A, Li Q, Gideon R, Castell D. Manometric abnormalities of the oesophagus in patients with Parkinson's disease. Neurogastroenterol Motil. 2001;13:361-4 pubmed
    ..This may reflect selective involvement of either the dorsal motor nucleus of the vagus or the oesophageal myenteric plexus. ..
  42. Floch M, Lacy B. Esophageal reflux and motility update: GERD, NERD and spasm. Introduction. J Clin Gastroenterol. 2008;42:557 pubmed publisher
  43. Weiss A, Iorio N, Schey R. Esophageal motility in eosinophilic esophagitis. Rev Gastroenterol Mex. 2015;80:205-13 pubmed publisher
    ..Esophageal manometry findings vary from normal motility to aperistalsis, simultaneous contractions, diffuse esophageal spasm, nutcracker esophagus or hypotonic lower esophageal sphincter (LES)...
  44. Rees C, Belafsky P. Distal esophageal spasm. Ear Nose Throat J. 2007;86:336 pubmed
  45. Leconte M, Douard R, Gaudric M, Dousset B. [Surgical management of primary esophageal motility disorders]. J Chir (Paris). 2008;145:428-36 pubmed
    Primary esophageal motility disorders are rare, the most common diagnoses being achalasia and diffuse esophageal spasm. Treatment aims to alleviate symptoms and may be medical, endoscopic, or surgical...
  46. Chone C, Teixeira C, Andreollo N, Spina A, Barcelllos I, Quagliato E, et al. Botulinum toxin in speech rehabilitation with voice prosthesis after total laryngectomy. Braz J Otorhinolaryngol. 2008;74:230-4 pubmed
    ..Acoustic analysis showed an improvement in harmonics quality after treatment. There was smoother voice utterance and spasm improvement after BT. all patients with PES spasms presented vocal improvement after BT injection in the PES. ..
  47. Deng B, Wang R, Jiang Y, Tan Q, Liao X, Zhou J, et al. Diagnosis of chest pain with foregut symptoms in Chinese patients. World J Gastroenterol. 2009;15:742-7 pubmed
    ..Spasm of the esophageal smooth muscle might affect the heart-coronary smooth muscle, leading to myocardial ischemia. ..
  48. Leconte M, Douard R, Gaudric M, Dumontier I, Chaussade S, Dousset B. Functional results after extended myotomy for diffuse oesophageal spasm. Br J Surg. 2007;94:1113-8 pubmed
    ..Extended myotomy with anterior fundoplication is an effective treatment for severe DOS. Medium-term postoperative functional results were excellent, especially in terms of dysphagia and chest pain. ..
  49. Schneider J, Kuper M, Konigsrainer A, Brücher B. Transient lower esophageal sphincter relaxation in morbid obesity. Obes Surg. 2009;19:595-600 pubmed publisher
  50. Maruyama K, Motoyama S, Okuyama M, Ohta H, Ogawa J. Successful surgical treatment for diffuse esophageal spasm. Jpn J Thorac Cardiovasc Surg. 2005;53:169-72 pubmed
    ..Barium swallow examination revealed the esophagus to have the corkscrew appearance characteristic of diffuse esophageal spasm (DES)...
  51. Maccarini P. Oesophageal motility disorders. Lancet. 2002;359:170 pubmed
  52. Spencer H, Smith L, Riley S. A questionnaire study to assess long-term outcome in patients with abnormal esophageal manometry. Dysphagia. 2006;21:149-55 pubmed
    ..Four main manometric abnormalities have been described: achalasia, diffuse esophageal spasm, "nutcracker" (hypercontracting) esophagus, and hypocontracting esophagus...
  53. Cameron R, Barclay M, Dobbs B. Ambulatory oesophageal manometry and pH monitoring for investigation of chest pain: a New Zealand experience. N Z Med J. 2006;119:U1877 pubmed
    ..Oesophageal spasm appears to be a rare cause of chest pain in Christchurch. When a diagnosis was made on AMP, it was most often gastro-oesophageal reflux disease. ..