Esophageal motor disorders: achalasia and esophageal spasm

To define the esophageal motor disorders of achalasia and esophageal spasms and describe their presentation in the clinical setting.

Selected research-based articles, textbooks, and expert opinion. A case study is presented.

The presentation of esophageal motor disorders may not be clear, particularly when the presenting symptom is chest pain. Determining whether the pain is cardiac or digestive in origin is crucial.

Progressive dysphagia for both solids and liquids is the major symptom of achalasia; other symptoms include regurgitation, chest pain, and nocturnal cough. Diffuse esophageal spasm typically causes substernal chest pain with nonprogressive dysphagia and odynophagia for both liquids and solids. Dysphagia related to esophageal motility is characterized by a sensation of swallowed food "sticking" in the throat or chest; there is no problem initiating the act of swallowing.