Zaher Eli A, Patel Parth, Atia George, Sigdel Surendra
Internal Medicine, Ascension Health - Saint Joseph Hospital, Chicago, USA.
Gastroenterology and Hepatology, Ascension Health - Saint Joseph Hospital, Chicago, USA.
Cureus. 2023 Jul 7;15(7):e41504. doi: 10.7759/cureus.41504. eCollection 2023 Jul.
Distal esophageal spasm is characterized by premature contractions of the distal esophageal smooth muscle leading to non-obstructive dysphagia and non-cardiac chest pain. Diagnosis requires the presence of symptoms along with evidence of at least 20% premature contractions in the setting of a normal lower esophageal sphincter relaxation on high-resolution manometry. New updates to the Chicago Classification have improved the diagnostic accuracy of this method. Functional lumen imaging probe is a growing diagnostic modality that gives a more complete picture of esophageal motility. Pharmacologic treatment remains inadequate. Endoscopic myotomy might be of benefit for non-achalasia esophageal motility disorders. More research is required to better understand the pathophysiology and develop safe and long-lasting management for this disease.
食管远端痉挛的特征是食管远端平滑肌过早收缩，导致非梗阻性吞咽困难和非心源性胸痛。诊断需要有症状，同时在高分辨率测压时食管下括约肌松弛正常的情况下，至少有20%过早收缩的证据。芝加哥分类法的新更新提高了这种方法的诊断准确性。功能性管腔成像探头是一种不断发展的诊断方式，能更全面地显示食管动力情况。药物治疗仍然效果不佳。内镜下肌切开术可能对非贲门失弛缓症食管动力障碍有益。需要更多研究来更好地理解其病理生理学，并为这种疾病开发安全且持久的治疗方法。
