Esophageal spasm can be divided into 2 major variants that are distinct entities: (1) diffuse esophageal spasm and (2) hypertensive peristalsis. Symptoms can include dysphagia, regurgitation, and noncardiac chest pain.
It is rare, with an incidence between 8 and 19 cases per million per year. The peak incidence occurs in the fourth through the sixth decade of life, affecting females four times greater than males. The prevalence is reported to be about 150 per million, with greater prevalence in nonwhite ethnic groups.
Treatment includes calcium channel blockers, botulinum toxin, nitrates, tricyclic antidepressants, sildenafil, dilatation, myotomy, and esophagectomy. the goal of treatment for foregut symptoms and signs is to ameliorate symptoms.
Because of the vague symptoms and difficulty in diagnosis, esophageal spasm is often underdiagnosed and therefore not adequately treated. Currently, high-resolution manometry is the best diagnostic modality.