Diffuse esophageal spasm diagnostic study of choice

	Diffuse esophageal spasm Microchapters
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Diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]

Overview

The page name should be "Diagnostic study of choice for [disease name]", with only the first letter of the title capitalized. Note that the page is called "Diagnostic study of choice."
Goal:
- To describe the most efficient/sensitive/specific test that is utilized for diagnosis of [disease name].
- To describe the gold standard test for the diagnosis of [disease name].
- To describe the diagnostic criteria, which may be based on clinical findings, physical exam signs, pathological findings, lab findings, findings on imaging, or even findings that exclude other diseases.
As with all microchapter pages linking to the main page, at the top of the edit box put {{CMG}}, your name template, and the microchapter navigation template you created at the beginning.
Remember to create links within WikiDoc by placing [[square brackets]] around key words which you want to link to other pages. Make sure you makes your links as specific as possible. For example, if a sentence contained the phrase anterior spinal artery syndrome, the link should be to anterior spinal artery syndrome not anterior or artery or syndrome. For more information on how to create links, click here.
Remember to follow the same format and capitalization of letters as outlined in the template below.
You should include the name of the disease in the first sentence of every subsection.

Conventional manometry testing is the gold standard test for the diagnosis of DES.

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.

DES is diagnosed based on The Chicago Classification v.3.0
On conventional manometry, > 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.

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