gastrointestinal disorders
Diffuse Esophageal Spasm
Treatment of Diffuse Esophageal Spasm
Calcium channel blockers Botulinum toxin injection Sometimes surgical or endoscopic myotomy Esophageal spasms are often difficult to treat, and controlled studies of treatment methods are lacking. Anticholinergics, tricyclic antidepressants,nitroglycerin, and long-acting nitrates have had limited success. Calcium channel blockers given orally (eg,verapamil80 mg 3 times a day,nifedipine10 mg 3 times a day) may be useful. Rarely, a trial of injecting botulinum toxin type A into the esophagus and/or lower esophageal sphincter is done. Medical management is usually sufficient, but surgical or peroral endoscopic myotomy along the full length of the esophagus has been tried in severe cases. 