Diffuse esophageal spasm diagnostic study of choice: Difference between revisions
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{{Diffuse esophageal spasm}} | {{Diffuse esophageal spasm}} | ||
== Overview. == | == Overview. == | ||
The diagnostic study of choice for DES is manometry. | The diagnostic study of choice for DES is [[manometry]]. | ||
== Diagnostic Study of Choice for DES == | == Diagnostic Study of Choice for DES == | ||
=== Gold standard/Study of choice: === | === Gold standard/Study of choice: === | ||
* Conventional manometry testing is the gold standard test for the diagnosis of DES. | * Conventional [[manometry]] testing is the gold standard test for the diagnosis of DES. | ||
===== Sequence of Diagnostic Studies ===== | ===== Sequence of Diagnostic Studies ===== | ||
The upper GI endoscopy, | The [[Endoscopy|upper GI endoscopy]], [[barium swallow]], [[PH meter|esophageal PH monitoring]] and [[manometry]] should be performed after an [[ECG]] and [[Cardiac Biomarkers|cardiac work up]] when: | ||
* The patient presented with chest pain and/or dysphagia as the first step of diagnosis. | * The patient presented with [[chest pain]] and/or [[dysphagia]] as the first step of diagnosis. | ||
=== Diagnostic Criteria === | === Diagnostic Criteria === | ||
*DES is diagnosed based on The Chicago Classification v.3.0 | *DES is diagnosed based on The Chicago Classification v.3.0 | ||
*On conventional manometry, | *On conventional [[manometry]], greater than or equal to 20% or more of simultaneous contractions (amplitude > 30 mm Hg) defines DES. | ||
*On high resolution manometry (HRM), greater or equal to 20% premature contractions (with distal latency < 4.5 seconds) defines DES. | *On high resolution [[manometry]] (HRM), greater or equal to 20% premature contractions (with distal latency < 4.5 seconds) defines DES. | ||
*Manometric presentation is intermittent and may not be present on each swallow during testing. | *Manometric presentation is intermittent and may not be present on each swallow during testing. | ||
==References== | ==References== | ||
Latest revision as of 20:32, 28 November 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]
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Overview.
The diagnostic study of choice for DES is manometry.
Diagnostic Study of Choice for DES
Gold standard/Study of choice:
- Conventional manometry testing is the gold standard test for the diagnosis of DES.
Sequence of Diagnostic Studies
The upper GI endoscopy, barium swallow, esophageal PH monitoring and manometry should be performed after an ECG and cardiac work up when:
- The patient presented with chest pain and/or dysphagia as the first step of diagnosis.
Diagnostic Criteria
- DES is diagnosed based on The Chicago Classification v.3.0
- On conventional manometry, greater than or equal to 20% or more of simultaneous contractions (amplitude > 30 mm Hg) defines DES.
- On high resolution manometry (HRM), greater or equal to 20% premature contractions (with distal latency < 4.5 seconds) defines DES.
- Manometric presentation is intermittent and may not be present on each swallow during testing.