“Esophageal spasm”的意思、由来-开放百科全书

词条

Esophageal spasm

释义

Symptoms
Causes
Treatment
Notes

Esophageal spasm or oesophageal spasm is a disorder of esophageal motility. The esophagus is an organ in vertebrates which consists of a fibromuscular tube through which food passes, aided by peristalsis contractions, from the upper esophageal sphincter to the stomach through waves of coordinated muscle contraction, or peristalsis.^[1]

There are two types of esophageal spasm:

Diffuse esophageal spasm (DES), where there is uncoordinated esophageal contractions where several sections of the esophagus can contract at once.
Nutcracker esophagus (NE) also known as hypertensive peristalsis, where the contractions are coordinated but with an excessive amplitude.

Both conditions can be linked with Gastroesophageal reflux disease (GERD).^[1] DES and nutcracker esophagus are clinically indistinguishable and can only be differentiated by performing esophageal manometry.

When the coordinated muscle contraction are irregular or uncoordinated, this condition may be called diffuse esophageal spasm. These spasms can prevent food from reaching the stomach where food gets stuck in the esophagus. At other times the coordinated muscle contraction is very powerful, which is called nutcracker esophagus. These contractions move food through the esophagus but can cause severe pain.^[2]

Symptoms

Esophageal spasm is rare. Often, symptoms that may suggest esophageal spasm are the result of another condition such as gastroesophageal reflux disease (GERD) or achalasia.^[2] The symptoms can also include dysphagia, regurgitation, noncardiac chest pain,^[3] heartburn,^[4] globus pharyngis (which is a feeling that something is stuck in the throat) or a dry cough.^[5]

Causes

It is not clear exactly what causes esophageal spasms.^[5] Sometimes esophageal spasms start when someone eats hot or cold foods or drinks. However, they can also occur with eating or drinking.^[5] The increased release of acetylcholine may also be a factor, but the triggering event is not known.^[4]

Treatment

Since esophageal spasms are often associated with other disorders, management in these cases involve attempts to correct the underlying problem (eg: GERD, stress, anxiety).

Pharmacotherapy options include use of calcium channel blockers (CCBs) and nitrates. Tricyclic antidepressants (TCA) and sildenafil can be used as alternative treatment options.

If medical therapy fails, or in extreme cases, surgical approach with a myotomy can be used to relieve the symptoms.

Notes

1. ^¹{{cite web |url= http://patient.info/doctor/oesophageal-spasm|publisher= EMIS Health |title= Oesophageal Spasm|accessdate= 2015-11-15}}
2. ^¹{{cite web |url= http://www.webmd.com/digestive-disorders/tc/esophageal-spasm-topic-overview|publisher= WebMD |title= Esophageal Spasm - Topic Overview|accessdate= 2015-11-15}}
3. ^{{cite web |url= http://emedicine.medscape.com/article/174975-overview|publisher= WebMD |title= Esophageal Spasm|accessdate= 2015-11-15}}
4. ^¹{{cite web |url= http://emedicine.medscape.com/article/174975-clinical|publisher= WebMD |title= Esophageal Spasm Clinical Presentation - History|accessdate= 2015-11-15}}
5. ^¹²{{cite web |url= https://my.clevelandclinic.org/health/diseases_conditions/hic-esophageal-spasms-strictures|publisher= Cleveland Clinic |title= Esophageal Spasms & Strictures|accessdate= 2015-11-15}}

3 : Abdomen|Digestive system|Diseases of oesophagus, stomach and duodenum

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