A nonprogressive dysmotility disorder of the oesophagus which primarily affects older adults. While it may be asymptomatic, it often manifests itself as chest pain, less commonly as dysphagia for solid and liquid foods
Diagnosis Oesophageal manometry; the diagnosis is made at intraoesophageal pressure above 180 mm Hg, a pressure fancifully likened to that of a nutcracker, hence the name
Management
• Reduce risk factors Weight loss; it is unclear if acid suppression, to reduce oesophageal reflux, is effective
• Medical therapy Calcium-channel blockers to relax the lower oesophageal sphincter (LOS) and reduce dysphagia; diltiazem; nitrates—e.g., pre-prandial isosorbide dinitrate—may also relax the LOS; phosphodiesterase inhibitors—e.g., sildenafil—may be of use; trazodone, an anti-depressant, may reduce visceral sensitivity and chest pain
• Endoscopic therapy Botulinum toxin (Botox) temporarily improves symptoms; balloon dilation to stretch LOS muscles may improve work
• Surgery As a last resort, a Heller myotomy can disrupt the LOS and the myenteric plexus that innervates it.

nutcracker esophagus

Corkscrew esophagus, see there.

References in periodicals archive

Esophageal intramural pseudodiverticulosis and nutcracker esophagus are rare causes of food impaction.

Complete gastroesophageal obstruction by food bolus

Patients with ES can present with chest pain, but often this is more indicative of reflux or nutcracker esophagus. Patients will often complain of dysphagia and possibly regurgitation.

Esophageal spasm

The criteria included achalasia, diffuse esophageal spasm, nutcracker esophagus, and hypertensive lower esophageal sphincter (LES) pressure, Dr.

Spastic esophageal dysmotility seen in patients using opioids

Findings from an uncontrolled study showed that treatment with a proton pump inhibitor and trazodone improved severe, spasmodic chest pains in 80% of a group of patients with "nutcracker esophagus," a motility disorder characterized by high-amplitude peristaltic contractions arising from the distal esophagus.

The 'omeprazole test'. (GI Disorders)

There's a medical condition called "nutcracker esophagus" characterized by extremely painful swallowing; a calligraphic typeface designed by Richard Lipton for publisher David Godine's Christmas book on ballet; porting software called NuTCRACKER; a recording of a klezmer Nutcracker available from Newport Classics; Nutcracker Ale and a Nutcracker Shooter (vodka, Frangelico and cream); even a Nutcracker Golf and Health Club at Pecan Plantation, Texas.

NUTCRACKERS, NOTCRACKERS AND JOY TO THE WORLD

Esophageal motility disorders (distal esophageal spasm, nutcracker esophagus, and hypertensive lower esophageal sphincter): Modern management.

Distal esophageal spasm

This is an exciting finding because currently there is no approved treatment for esophageal hypersensitivity, which is an important cause of functional noncardiac chest pain or "nutcracker esophagus," a common and vexing problem, said Dr.

Theophylline for 'nutcracker esophagus'. (Noncardiac Chest Pain)