WordNet

a painful and involuntary muscular contraction (同)cramp, muscle_spasm
(pathology) sudden constriction of a hollow organ (as a blood vessel)
relating to the esophagus

PrepTutorEJDIC

(筋肉などの)けいれん / (感情・活動などの)発作《+『of』+『名』》
鉱泉,温泉 / 温泉場

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/12/23 17:42:27」(JST)

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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[edit]

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.^[1]

Causes[edit]

Causes of diffuse esophageal spasm are not well understood. It is clear, however, that many cases are caused by uncontrolled gastroesophageal reflux^{[citation needed]}. Therefore, an empiric trial of acid suppression medication is often the first line therapy. It has also been reported that very cold or hot beverages can trigger an esophageal spasm, and avoidance therapy benefits some people.

Radiography[edit]

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.

References[edit]

^ "Medscape: Medscape Access". Emedicine.medscape.com. 2013-02-14. Retrieved 2013-06-10.

External links[edit]

Barium swallow images of DES^{[dead link]}

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. 肥満手術後の画像検査 imaging studies after bariatric surgery
5. 全身性硬化症（強皮症）の消化器症状 gastrointestinal manifestations of systemic sclerosis scleroderma

English Journal

Treatment of esophageal motility disorders based on the chicago classification.

Maradey-Romero C1, Gabbard S, Fass R.
Current treatment options in gastroenterology.Curr Treat Options Gastroenterol.2014 Dec;12(4):441-55. doi: 10.1007/s11938-014-0032-9.
OPINION STATEMENT: The Chicago Classification divides esophageal motor disorders based on the recorded value of the integrated relaxation pressure (IRP). The first group includes those with an elevated mean IRP that is associated with peristaltic abnormalities such as achalasia and esophagogastric j
PMID 25263532

The Chicago Classification of motility disorders: an update.

Roman S1, Gyawali CP2, Xiao Y3, Pandolfino JE4, Kahrilas PJ5.
Gastrointestinal endoscopy clinics of North America.Gastrointest Endosc Clin N Am.2014 Oct;24(4):545-61. doi: 10.1016/j.giec.2014.07.001. Epub 2014 Aug 1.
The Chicago Classification defines esophageal motility disorders in high resolution manometry. This is based on individual scoring of 10 swallows performed in supine position. Disorders of esophago-gastric junction (EGJ) outflow obstruction are defined by a median integrated relaxation pressure abov
PMID 25216902

Botulinum toxin injection for hypercontractile or spastic esophageal motility disorders: may high-resolution manometry help to select cases?

Marjoux S1, Brochard C, Roman S, Gincul R, Pagenault M, Ponchon T, Ropert A, Mion F.
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E.Dis Esophagus.2014 Sep 12. doi: 10.1111/dote.12282. [Epub ahead of print]
Endoscopic injections of botulinum toxin in the cardia or distal esophagus have been advocated to treat achalasia and spastic esophageal motility disorders. We conducted a retrospective study to evaluate whether manometric diagnosis using the Chicago classification in high-resolution manometry (HRM)
PMID 25212219

Japanese Journal

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