Diffuse esophageal spasm history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]

The hallmark of DES is esophageal dysphagia for both solids and liquids and chest pain. Symptom onset is sudden, intermittent and non-progressive in nature. Chest pain usually retrosternal in location, which is intense and squeezing in nature and may be mistaken for Angina. Difficulty swallowing, is sometimes related to specific substances like red wine, very cold or hot liquid.

Primary DES is less common than secondary DES. Patients with DES may have a positive history of:^[1][2]

• Dysphagia for both solids and liquids.
• Sensation of food sticking in the esophagus after swallowing. However, there is no difficulty initiating the process of swallowing.

Common symptoms of DES include:

• Symptom onset is sudden, intermittent and non-progressive in nature.
• Chest pain usually retrosternal in location, which is intense and squeezing in nature and may be mistaken for Angina.
• Difficulty swallowing, sometimes related to specific substances like red wine, very cold or hot liquid.
• Regurgitation of swallowed food.
• Odynophagia for both solids and liquids.

Less common symptoms of DES include

• Weight loss
• Heartburn
• Symptoms related to secondary diseases.
  • Raynaud’s phenomenon (RP) is seen in DES associated with scleroderma. However, degree of esophageal motility dysfunction cannot be predicted based on RP.^[3]

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