Summary of Diffuse esophageal spasm
Diffuse esophageal spasm (aka "nutcracker esophagus") is a condition characterized by uncoordinated contractions of the esophagus, which causes dysphagia and severe retrosternal chest pain mimicking that of myocardial ischemia. The pain is settled by nitrates, again like cardiac pain. The most accurate test is esophageal manometry, which shows high-intensity, disorganized contractions. Barium studies may show a "corkscrew" pattern of the esophagus at the time of the pain. Treatment is with calcium channel blockers and nitrates.