What is the role of barium swallow in the workup of esophageal spasm?

Updated: Aug 07, 2019
  • Author: Ahmad Malas, MD; Chief Editor: BS Anand, MD  more...
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Barium swallow or esophagram is the best imaging study to aid in the diagnosis of esophageal spasm by evaluating for nonpropulsive contractions in the esophagus.

Diffuse esophageal spasm has a characteristic appearance of multiple simultaneous contractions causing a corkscrew appearance with segmentation (see the image below).

Barium swallow demonstrates diffuse uncoordinated Barium swallow demonstrates diffuse uncoordinated contractions of the esophagus in a patient with diffuse esophageal spasm.

Unlike in diffuse esophageal spasm, the barium swallow findings for nutcracker esophagus are not specific and can present minimal findings.

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