How is dx and tx of diffuse esophageal spasm?

III. Diagnosis: A. Manometry: reveals high-amplitude simultaneous, multiphasic contractions with a normal sphincteric response to swallowing B. Contrast esophagram: may show a corkscrew appearance of the esophagus IV. Treatment: • Less satisfactory than in achalasia • Avoidance of “trigger” foods and drinks • Medical therapy: calcium channel blockers and smooth muscle relaxants (nitrates) • Endoscopic therapy: Botulinum toxin injected into the spastic segment may provide relief .