User:Mr. Ibrahem/Distal esophageal spasm

Distal esophageal spasm (DES), also known as diffuse esophageal spasm, is a condition in which there is uncoordinated contractions of the esophagus. Symptoms may include difficulty swallowing, regurgitation, felling like something is stuck in the throat, and chest pain. Difficulty swallowing may occur with both solids and liquids. Complications may rarely include achalasia.

The cause is unknown. Episodes may be triggered by eating quickly or foods at extremes of temperature. Risk factors include GERD, obesity, high cholesterol, and high blood sugar. While the esophageal contractions are uncoordinated they are of normal strength and the lower esophagus opens normally. Diagnosis may be supported by esophageal manometry, with testing such as endoscopy and barium swallow done to rule out other causes. It is a type of esophageal motility disorder.

Treatment options include peppermint oil, nitrates, calcium channel blockers, esophageal dilation, and botulinum toxin injects. Proton-pump inhibitors may be used to treat associated GERD. Rarely surgery may be carried out. Outcomes are variable.

Diffuse esophageal spasm affects about 1 per 100,000 people per year. It represents less than 10% of no heart related chest pain. It is most common in those around the age of 60 and women are affected more often than men. The condition was first described in 1889 by Osgood.