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Nutcracker esophagus is one of several motility disorders of the esophagus, including achalasia and diffuse esophageal spasm. It causes difficulty swallowing ( dysphagia ) with both solid and liquid foods, and can cause significant chest pain ; it may also be asymptomatic.
Nutcracker esophagus is characterized by high-amplitude peristaltic contractions that are frequently prolonged and cause dysphagia and chest pain. [6] HLES (hypertensive lower esophageal sphincter) is a rare manometric abnormality seen among individuals with dysphagia, chest pain, gastroesophageal reflux, and hiatal hernia. [7]
Achalasia is an idiopathic motility disorder characterized by failure of lower esophageal sphincter (LES) relaxation as well as loss of peristalsis in the distal esophagus, which is mostly smooth muscle. Both of these features impair the ability of the esophagus to empty contents into the stomach.
Esophagogastric junction outflow obstruction (EGJOO) is an esophageal motility disorder characterized by increased pressure where the esophagus connects to the stomach at the lower esophageal sphincter. EGJOO is diagnosed by esophageal manometry.
Esophageal spasm is a disorder of motility of the esophagus. [2] There are two types of esophageal spasm: [2] Diffuse or distal esophageal spasm (DES), where there is uncoordinated esophageal contractions; Nutcracker esophagus (NE) also known as hypertensive peristalsis, where the contractions are coordinated but with an excessive amplitude.
An EMS is typically done to evaluate suspected disorders of motility or peristalsis of the esophagus. These include achalasia, diffuse esophageal spasm, nutcracker esophagus and hypertensive lower esophageal sphincter. These disorders typically present with dysphagia, or difficulty swallowing, usually to both solids and liquids even initially.
GERD can cause inflammation of the lower esophagus caused by chronic acid reflux, making it hard to swallow. Related: The 7-Day GERD Diet Plan Registered Dietitians Swear By
The abdominal pain may improve or worsen depending on positioning. [5] Patients may also have orthostatic proteinuria, or the presence of protein in their urine depending on how they sit or stand. [6] Since the left gonadal vein drains via the left renal vein, it can also result in left testicular pain [7] in men or left lower quadrant pain in ...