Diffuse esophageal spasm historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]

Historical Perspective

Discovery

• DES was first described by Osgood, in 1889 in 6 patients who presented with chest pain and dysphagia.

• Creamer (1954) made the first manometric descriptions of DES.

Landmark Events in the Development of Treatment Strategies

• In 2000, development of high resolution esophageal manometry has led to classification of esophageal motility disorders.

Pathophysiology

Pathogenesis

• The exact pathogenesis of DES is not fully understood. However, current high-resolution manometry studies suggest impairment of inhibitory myenteric plexus neuron. These neurons use nitric oxide (NO) as neurotransmitter. Hence, these patients may also have dysregulation of endogenous NO synthesis or/and degradation. The final result is premature and rapidly propagated or simultaneous contraction of smooth muscles of distal esophagus.