Oesophageal Dysmotility and Spasm

This term describes a group of conditions which lead to symptoms of impaired or difficult swallowing and, or chest pain with or without swallowing. The symptoms are due to uncordination of the oesophageal muscles. In normal function a smooth wave of contraction, with a corresponding wave of relaxation within the segment just in front of the contraction, makes its way down the oesophagus to the lower oesophageal sphincter which relaxes at the time of the swallow to allow food to pass from the oesophagus into the stomach. In patients with dysmotility this smooth wave of contraction becomes broken and fragmented leading to a poorly co-ordinated swallow and corresponding difficulty swallowing. Liquids and solid swallows may be impaired. Dysmotility may be primary (a problem with the way the nerves in the oesophagus work) or secondary to other diseases such as reflux or scleroderma.