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Home uncategorized Diffuse Esophageal Spasm (DES)

Diffuse Esophageal Spasm (DES)

Table Of Contents

    General information and clinical

    • It is generally seen in young-middle-aged female patients.
    • Retrosternal pain along with dysphagia are the most important symptoms. Pain is more prominent than dysphagia.
    • The most important features are that the symptoms are intermittent, the pain lasts for a long time, and it can be aggravated by food and emotional stress.
    • A similar picture can be seen in amyotrophic lateral sclerosis, a systemic disease.

    Diagnosis
    • Corkscrew appearance is typical in barium esophageal radiography.
    • Endoscopy is usually normal.
    • Definitive diagnosis is made by manometry. In manometry; Irregular, prolonged, repetitive and non-propulsive (non-progressive) spastic contractions are seen. LES relaxation and pressure are usually normal.

    Treatment
    • Foods that can aggravate symptoms should be avoided, emotional stress and anxiety should be reduced (antidepressant, anxiolytic).
    • Drugs that relax smooth muscles in medical treatment; nifedipine and nitrates can be used.
    Botulismus toxin injection can be tried in selected cases.
    • Dilatation or surgical myotomy can be applied in selected cases unresponsive to medical treatment.
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