Key Features of Oesophageal Spasms



1. Intermittent chest pain, often described as squeezing or pressure
2. Dysphagia (difficulty swallowing)
3. Regurgitation of food
4. Pain triggered by eating, drinking cold beverages, or stress

Physical Examination:

Typically normal, as oesophageal spasms are not associated with physical findings.

Diagnostic Tests:

i. Esophagogastroduodenoscopy (EGD): Often normal in oesophageal spasms, used to rule out other causes.
ii. Oesophageal Manometry: The gold standard for diagnosing oesophageal spasms, shows abnormal oesophageal contractions.
iii. Barium Swallow: May show corkscrew oesophagus in diffuse oesophageal spasm.

. Calcium Channel Blockers (e.g., diltiazem or nifedipine): First-line treatment to relax oesophageal smooth muscle.
. Nitrates (e.g., nitro-glycerine): Can be used for acute relief but not typically first-line due to side effects.
. Tricyclic Antidepressants (e.g., amitriptyline): For patients with refractory symptoms.
. Lifestyle Modifications: Avoiding trigger foods and stress management.

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