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| {{CMG}}; {{AE}}Madhu Sigdel | | {{CMG}}; {{AE}} |
| | ==Overview== |
| | The majority of patients with [disease name] are asymptomatic. |
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| == Historical Perspective ==
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| === Discovery ===
| | The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. |
| * DES was first described by Osgood, in 1889 in 6 patients who presented with chest pain and dysphagia.<ref name="pmid248038782">{{cite journal| author=Achem SR| title=Diffuse esophageal spasm in the era of high-resolution manometry. | journal=Gastroenterol Hepatol (N Y) | year= 2014 | volume= 10 | issue= 2 | pages= 130-3 | pmid=24803878 | doi= | pmc=4011379 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24803878 }}</ref>
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| * Creamer (1954) made the first manometric descriptions of DES. | | ==History and Symptoms== |
| References
| | *The majority of patients with [disease name] are asymptomatic. |
| | OR |
| | *The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. |
| | *Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. |
| | ===History=== |
| | Patients with [disease name]] may have a positive history of: |
| | *[History finding 1] |
| | *[History finding 2] |
| | *[History finding 3] |
| | ===Common Symptoms=== |
| | Common symptoms of [disease] include: |
| | *[Symptom 1] |
| | *[Symptom 2] |
| | *[Symptom 3] |
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| == Classification of DES == | | ===Less Common Symptoms=== |
| * There is no established system for the classification of DES although it is categorized as one of the major disorders of peristalsis according to The Chicago Classification v.3.0. | | Less common symptoms of [disease name] include |
| | *[Symptom 1] |
| | *[Symptom 2] |
| | *[Symptom 3] |
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| == Risk Factors == | | ==References== |
| * Common risk factors in the development of Diffuse Esophageal Spasm include Age (60-80 years), presence of GERD, Hypertension, anxiety or depression, and drinks (eg. red wine, very hot or cold liquid or fluid).
| | {{Reflist|2}} |
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| == Pathophysiology ==
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| === Pathogenesis ===
| | [[Category: (name of the system)]] |
| * The exact pathogenesis of DES is not fully understood. However, current high-resolution manometric 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<ref name="pmid4196712">{{cite journal| author=Orlando RC, Bozymski EM| title=Clinical and manometric effects of nitroglycerin in diffuse esophageal spasm. | journal=N Engl J Med | year= 1973 | volume= 289 | issue= 1 | pages= 23-5 | pmid=4196712 | doi=10.1056/NEJM197307052890106 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4196712 }}</ref>. The final result is premature and rapidly propagated or simultaneous contraction of smooth muscles of distal esophagus.
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| References<references />
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| == Natural History, Complications, and Prognosis ==
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| === Natural History ===
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| * The symptoms of DES usually develop in the fifth decade of life, and start with dysphagia for both solids and liquids.
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| * If left untreated, 4% of patients with DES may progress to develop Achalasia while most are asymptomatic.
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| === Complications ===
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| * Common complications of [disease name] include:
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| ** [Complication 1]
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| ** [Complication 2]
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| ** [Complication 3]
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| === Prognosis ===
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| * Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
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| * Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
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| * The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
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| * [Subtype of disease/malignancy] is associated with the most favorable prognosis.
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| * The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
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| == References ==
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| == Diagnostic Criteria ==
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| * The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
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| {{family tree//start}}
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| {{family tree ||||A01||||A02||||}}
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| == References ==
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms
- The majority of patients with [disease name] are asymptomatic.
OR
- The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
- Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History
Patients with [disease name]] may have a positive history of:
- [History finding 1]
- [History finding 2]
- [History finding 3]
Common Symptoms
Common symptoms of [disease] include:
- [Symptom 1]
- [Symptom 2]
- [Symptom 3]
Less Common Symptoms
Less common symptoms of [disease name] include
- [Symptom 1]
- [Symptom 2]
- [Symptom 3]
References
Template:WH
Template:WS