Diffuse esophageal spasm: a case study

Abstract

The esophagus functions to transport food and liquid from the pharynx to the stomach. It is comprised of striated and smooth muscle and has specialized sphincters at its proximal (upper) and distal (lower) ends. Its muscle action produces the sequential, coordinated peristalsis that propels food and liquid distally. This peristaltic movement needs to have coordinated primary and secondary contractions. When these do not occur, tertiary contractions result. These contractions are dysfunctional and create a motility disorder of the esophagus. One such motility disorder is Diffuse Esophageal Spasm (DES). Symptoms of DES include atypical chest pain that can mimic angina, and dysphagia (swallowing difficulty), particularly a feeling of food or liquid being caught in the throat. DES is best confirmed through manometry, a procedure that assesses pressure, timing, and intensity of esophageal muscle movement, and radiography, or imaging, of the esophagus. The etiology of DES remains elusive. Treatment varies. This case study focuses on the diagnosis and successful treatment of an older adult with DES through speech-language pathology.