Esophageal spasm

Esophageal spasm is a disorder of motility of the esophagus.

There are two types of esophageal spasm:

• Diffuse or distal esophageal spasm (DES), where there is uncoordinated esophageal contractions
• Nutcracker esophagus (NE) also known as hypertensive peristalsis, where the contractions are coordinated but with an excessive amplitude.

Both conditions are linked to gastroesophageal reflux disease (GERD). DES and nutcracker esophagus present similarly and can may require esophageal manometry for differentiation.

When the coordinated muscle contraction are irregular or uncoordinated, this condition may be called diffuse esophageal spasm. These spasms can prevent food from reaching the stomach where food gets stuck in the esophagus. At other times the coordinated muscle contraction is very powerful, which is called nutcracker esophagus. These contractions move food through the esophagus but can cause severe pain.