How is diffuse esophageal spasm (DES) differentiated from achalasia?

Updated: Dec 29, 2017
  • Author: Eric A Gaumnitz, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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DES and vigorous achalasia can be confused, as both have the common feature of active, higher amplitude simultaneous contractions of the esophagus. Manometric criteria require that some normal esophageal peristalsis must be present intermittently for DES. In addition, LES relaxation, which commonly is incomplete in patients with achalasia, should be normal in patients with DES. This issue is further complicated in that DES may evolve into achalasia with time, so a continuum with progression to aperistalsis is likely.

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