Esophageal motility disorder
Alerts and Notices
Synopsis
- Diffuse esophageal spasm (DES) – Dysphagia to solids and liquids characterized by difficulty swallowing several seconds after initiating a swallow. Dysphagia is often associated with retrosternal chest pain, heartburn, and regurgitation of food.
- Nutcracker esophagus – Strong esophageal contractions associated with odynophagia or chest pain. Less commonly associated with regurgitation.
- Achalasia – Loss of ganglion cells in the LES, leading to hypertrophy of the LES and dilation of the proximal esophagus. Characterized by dysphagia, regurgitation, and chest pain. Esophagoscopy may show a corkscrew esophagus.
Codes
ICD10CM:K22.4 – Dyskinesia of esophagus
SNOMEDCT:
79962008 – Diffuse spasm of esophagus
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Gastroesophageal reflux disease
- Esophageal stricture, web, ring, diverticulum
- Malignancy (intrinsic: esophageal cancer; extrinsic: eg, lymphoma)
- Eosinophilic esophagitis
- Infectious esophagitis
- Peptic ulcer disease
- Acute coronary syndrome
- Coronary artery disease
- Asthma
- Pleurisy
- Musculoskeletal strain
- Pulmonary embolism
Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:12/14/2017
Last Updated:09/16/2020
Last Updated:09/16/2020