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# Diffuse and Segmental Esophageal Spasm - Primarily a disease of the esophageal body - Lesser degree of dysphagia - More chest pains - Less effect on the patient's general condition - LES usually shows a normal resting pressure and relaxation on swallowing* - Advanced disease: tertiary contractio...

# Diffuse and Segmental Esophageal Spasm - Primarily a disease of the esophageal body - Lesser degree of dysphagia - More chest pains - Less effect on the patient's general condition - LES usually shows a normal resting pressure and relaxation on swallowing* - Advanced disease: tertiary contractions appear helical (corkscrew esophagus* or pseudodiverticulosis) - Brought by circular muscle fibers oriented helically - Upon swallowing LES relaxes vs achalasia no relaxation # Nutcracker Esophagus - Super squeezer esophagus - Most common - A manometric abnormality: contractions with peak amplitudes greater than two SDs above the normal values in individual laboratories; contraction amplitudes in these patients can easily be above 400 mmHg*