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Related Concept Videos

Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Esophageal Varices-I: Introduction01:24

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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...

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Related Experiment Video

Updated: May 26, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
11:19

Robotic Myotomy and Partial Fundoplication for Achalasia

Published on: August 11, 2023

Distal esophageal spasm.

Sabine Roman1, Peter J Kahrilas

  • 1Digestive Physiology, Claude Bernard Lyon I University, Lyon, France. roman.sabine@gmail.com

Dysphagia
|January 5, 2012
PubMed
Summary
This summary is machine-generated.

Distal esophageal spasm (DES) is a rare motility disorder. High-resolution manometry redefines DES using distal latency, differentiating it from achalasia and guiding treatment.

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Area of Science:

  • Gastroenterology
  • Esophageal Motility Disorders
  • Neurogastroenterology

Background:

  • Distal esophageal spasm (DES) is an uncommon esophageal motility disorder causing dysphagia and chest pain.
  • Pathophysiology involves impaired esophageal inhibitory neural function.
  • Conventional manometry definitions are limited; high-resolution manometry offers improved diagnostics.

Purpose of the Study:

  • To redefine Distal Esophageal Spasm (DES) using high-resolution manometry and esophageal pressure topography (EPT).
  • To differentiate DES from other esophageal motility disorders like spastic achalasia.
  • To discuss current and emerging therapeutic options for DES.

Main Methods:

  • Utilizing high-resolution manometry and esophageal pressure topography (EPT).
  • Measuring distal latency (DL) to identify premature contractions.
  • Assessing esophagogastric junction (EGJ) relaxation.

Main Results:

  • Premature contractions (reduced DL) are more specific for DES in EPT.
  • DES is defined by premature contractions with normal EGJ relaxation.
  • Impaired EGJ relaxation with premature contractions indicates spastic achalasia.

Conclusions:

  • EPT provides a more precise definition of DES based on distal latency.
  • Distinguishing DES from spastic achalasia is crucial for appropriate management.
  • Pharmacological (sildenafil, botulinum toxin) and surgical options exist for refractory DES.