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Diffuse esophageal spasm: a reappraisal.

J E Richter, D O Castell

Annals of Internal Medicine

|February 1, 1984

Summary

This summary is machine-generated.

Diffuse esophageal spasm is diagnosed more often, but often confused with noncardiac chest pain. Definitive diagnosis requires simultaneous esophageal contractions during motility testing.

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Area of Science:

Gastroenterology
Esophageal Motility Disorders

Background:

Diffuse esophageal spasm (DES) diagnosis is increasing.
The term DES is often incorrectly used interchangeably with noncardiac chest pain.
Accurate diagnostic criteria for DES are needed.

Purpose of the Study:

To clarify the diagnostic criteria for diffuse esophageal spasm.
To differentiate DES from other esophageal motility disorders and noncardiac chest pain.

Main Methods:

Literature review of esophageal motility studies.
Analysis of motility patterns in healthy subjects and symptomatic patients.
Evaluation of diagnostic criteria based on manometric findings.

Main Results:

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Diffuse esophageal spasm diagnosis requires simultaneous esophageal contractions after at least 10% of wet swallows.

These simultaneous contractions must be intermixed with normal peristaltic contractions.

Other manometric findings like repetitive waves or high-amplitude contractions are not sufficient for diagnosis alone.

Conclusions:

The diagnosis of diffuse esophageal spasm should be reserved for patients with specific manometric findings.
Simultaneous esophageal contractions during wet swallows are the hallmark of diffuse esophageal spasm.
Distinguishing DES from noncardiac chest pain requires precise adherence to diagnostic criteria.