WordNet

spread out; not concentrated in one place; "a large diffuse organization"
move outward; "The soldiers fanned out" (同)spread, spread out, fan out
lacking conciseness; "a diffuse historical novel"
a painful and involuntary muscular contraction (同)cramp, muscle_spasm
(pathology) sudden constriction of a hollow organ (as a blood vessel)
(of light rays) subjected to scattering by reflection from a rough surface or transmission through a translucent material; "diffused light"
relating to the esophagus
spreading by diffusion (同)diffusive, dispersive, disseminative

PrepTutorEJDIC

〈光・熱・液体など〉‘を'散らす,放散する,拡散させる / 〈学問・知識など〉‘を'広める,普及させる / 散る,放散する,拡散する / 広まる,普及する / 広く散った,広がった / 〈文体などが〉締まりのない,散漫な
(筋肉などの)けいれん / (感情・活動などの)発作《+『of』+『名』》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/20 19:45:37」(JST)

wiki en

Diffuse esophageal spasm (DES) is a condition in which uncoordinated contractions of the esophagus occur. It is thought to result from motility disorders of the esophagus. These spasms do not propel food effectively to the stomach. It can cause dysphagia, regurgitation and chest pain.

Treatment

Several drugs, including nitroglycerin and calcium channel blockers are used to treat this condition. Acid suppression therapy, such as proton pump inhibitors, are often the first line therapy. Botulinum toxin, which inhibits acetylcholine release from nerve endings, injected above the lower esophageal sphincter may also be used in the treatment of DES. Small studies have suggested benefit from endoscopic balloon dilation in certain patients, but all of the above have a low percentage of success in treating the condition; whilst the treatments work in some sufferers, it does not work for everyone.^[1]

Causes

Causes of diffuse esophageal spasm are not well understood. It is thought, however, that many cases are caused by uncontrolled brain signals running to nerve endings. Therefore, suppression medication is often the first line therapy such as anti depressants and anti-epileptic medication are prescribed. It has also been reported that very cold or hot beverages can trigger an esophageal spasm, and avoidance therapy benefits some people, but it has not been medically proven.^{[citation needed]}

Radiography

Corkscrew appearance of the esophagus.

The condition is sometimes referred to as corkscrew esophagus, due to a characteristic appearance of the esophagus as a corkscrew on barium swallow x-rays.^{[citation needed]}

References

^ Esophageal Spasm~treatment at eMedicine

External links

Barium swallow images of DES

UpToDate Contents

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1. 食道運動障害：臨床症状、診断およびマネージメント esophageal motility disorders clinical manifestations diagnosis and management
2. Evaluation of the adult with chest pain of esophageal origin
3. 高解像度食道内圧検査 high resolution manometry
4. 成人における嚥下障害の概要 overview of dysphagia in adults
5. 肥満手術後の画像検査 imaging studies after bariatric surgery

English Journal

Esophageal motor dysfunction plays a key role in GERD with globus sensation - Analysis of factors promoting resistance to PPI therapy.

Tsutsui H, Manabe N, Uno M, Imamura H, Kamada T, Kusunoki H, Shiotani A, Hata J, Harada T, Haruma K.SourceDepartment of Internal Medicine, Division of Gastroenterology, Kawasaki Medical School , Kurashiki , Japan.
Scandinavian journal of gastroenterology.Scand J Gastroenterol.2012 Sep;8-9(47):893-9. Epub 2012 May 18.
Abstract Objective. Patients with gastroesophageal reflux disease (GERD) also have various extra-esophageal symptoms. Laryngopharyngeal reflux disease (LPRD) is a subtype of GERD associated with globus sensation, but proton pump inhibitor (PPI) therapy achieves disappointing results. This study
PMID 22594305

Symptomatic improvement of diffuse esophageal spasm after botulinum toxin injection.

Han JP, Hong SJ, Kim HI, Byun JM, Kim HJ, Ko BM, Lee JS, Lee MS.SourceDepartment of Internal Medicine, Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 420-767, Korea.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi.Korean J Gastroenterol.2012 Aug 25;60(2):109-12.
Diffuse esophageal spasm, an uncommon esophageal motility disorder, has recently been defined using high-resolution manometry. Patients with distal esophageal spasm usually complain of chest pain or dysphagia. The etiology and pathophysiology of this disorder are poorly known, and treatment options
PMID 22926122

Japanese Journal

自律訓練法の心理生理的効果と,心身症に対する奏効機序(<特集>心身医療の臨床に活かす自律訓練法)

岡孝和,小山央
心身医学 52(1), 25-31, 2012-01-01
自律訓練法は不安,抑うつ,怒りなどの陰性感情を低下させ,自己認知を積極的なものに変化させ自己受容を促すという心理的効果がある.練習中,中心後回などの手足の感覚に関連する部位に加えて,前頭前皮質や島皮質など,内部感覚や情動に関連する皮質機能の活動が亢進する.両腕が「重たい」,「温かい」という公式を裏づけるように,骨格筋の弛緩と末梢皮膚温の上昇が生じる.交感神経活動に対しては抑制的に作用する.迷走神経 …
NAID 110008897854

機能性食道疾患診療の実際(<特集>心身医学と消化器症状)

判田正典
心身医学 50(10), 923-930, 2010-10-01
機能性食道疾患の主症状は胸やけ,胸痛,嚥下障害であり,食道運動障害,胃食道逆流症(GERD),食道由来の非心臓性胸痛(NCCP)がその主体をなすが,互いにオーバーラップしている.診断としてまず上部消化管の器質的疾患や代謝性疾患,虚血性心疾患を除外したうえで,食道造影や食道内圧検査,食道24時間pHモニタリング,食道知覚検査が必要である.機能性食道疾患においてもRome III基準の分類は実際の臨床 …
NAID 110007730313