Distal Esophageal Spasm

Distal Esophageal Spasm is a condition affecting the esophagus, the tube that carries food from the mouth to the stomach. It causes abnormal, uncoordinated muscle contractions in the lower part of the esophagus, which can lead to chest pain and difficulty swallowing. These spasms disrupt the normal movement of food, sometimes causing it to get stuck or move slowly. The condition primarily impacts the muscular function of the esophagus and can mimic symptoms of heart problems. People with this disorder often experience episodes of intense discomfort and may have trouble eating certain foods. Understanding this condition helps explain why swallowing can become painful or challenging.

Distal Esophageal Spasm (DES) is a motility disorder characterized by simultaneous, uncoordinated contractions of the distal esophageal smooth muscle during swallowing. The core pathology involves abnormal neuromuscular signaling leading to premature or repetitive contractions that impair normal peristalsis. The exact cause is often idiopathic but may be related to altered inhibitory neurotransmission in the esophageal myenteric plexus. Clinically, DES presents with intermittent chest pain and dysphagia for solids and liquids, which can mimic angina or other esophageal disorders. It is important to distinguish DES from achalasia and other motility disorders due to differences in management. The disorder is diagnosed primarily by esophageal manometry, which reveals characteristic spastic contractions with preserved lower esophageal sphincter relaxation.