A case of symptomatic diffuse esophageal spasm during multiple rapid swallowing test on high-resolution manometry

J Neurogastroenterol Motil. 2010 Oct;16(4):433-6. doi: 10.5056/jnm.2010.16.4.433. Epub 2010 Oct 30.

Abstract

Diffuse esophageal spasm (DES) is an uncommon motility disorder of unknown etiology in which the abnormal motility has been offered as a possible cause for the patient's dysphagia or chest pain. Esophageal manometry is the gold standard for the diagnosis of DES and the diagnostic hallmark is identification of simultaneous contractions in at least 20% of wet swallows, alternating with normal peristalsis. Recently, a new diagnostic technique, high-resolution manometry has been reported to improve the accuracy and detail in describing esophageal function. We report a female patient with intermittent dysphagia and chest pain occurring only when swallowing a large amount of water. On HRM, this patient had esophageal spasms, increased pressurization front velocity attributable to rapid contractile wave front, associated with symptoms, which were provoked by a multiple rapid swallowing test, and thereby was diagnosed with DES.

Keywords: Chest pain; Esophageal spasm, diffuse; Manometry.