Diffuse esophageal spasm in children referred for manometry

Area of Science:

• Pediatric Gastroenterology
• Esophageal Motility Disorders
• Diagnostic Characterization

Background:

• Diffuse esophageal spasm (DES) is characterized by chest pain and dysphagia in adults.
• Its presentation and diagnosis in pediatric populations are less understood.
• Esophageal manometry is a key diagnostic tool for evaluating esophageal motility.

Purpose of the Study:

• To determine the frequency and characteristics of diffuse esophageal spasm (DES) in children aged 0 to 18 years.
• To identify presenting symptoms of DES in different pediatric age groups.
• To explore comorbidities associated with DES in children.

Main Methods:

• Retrospective chart review of 278 pediatric patients undergoing esophageal manometry.
• Analysis of patient diagnoses, chief complaints, and demographic data.
• Categorization of diagnoses including normal motility, nonspecific esophageal motility disorder, DES, and achalasia.

Main Results:

• Diffuse esophageal spasm (DES) was diagnosed in 13% (n=36) of pediatric patients.
• Food refusal was the most common complaint in children younger than 5 years with DES (58%).
• Chest pain was the predominant symptom in children older than 5 years with DES (33%).
• Comorbid medical conditions were present in 33 subjects with DES.

Conclusions:

• Diffuse esophageal spasm (DES) is an identifiable esophageal motility disorder in children.
• Symptom presentation varies by age, with food refusal being a key indicator in young children.
• DES should be considered in the differential diagnosis for pediatric patients presenting with unexplained food refusal or chest pain.