What is the recommended management for diffuse esophageal spasm?

The recommended management for diffuse esophageal spasm predominantly involves the use of antispasmodics. Diffuse esophageal spasm is characterized by intermittent contractions of the esophagus that are both uncoordinated and prolonged, leading to chest pain and dysphagia. Antispasmodics, such as dicyclomine or hyoscyamine, can help reduce the frequency and severity of spasms by relaxing the smooth muscle of the esophagus, alleviating symptoms for affected patients.

While other treatments may have some role in managing related symptoms or associated conditions, they are not the primary strategy for treating diffuse esophageal spasm. For instance, surgery is typically reserved for more severe motility disorders or structural abnormalities rather than primary diffuse esophageal spasm. High-dose proton pump inhibitors target acid reflux rather than the motility disorder itself. Increasing dietary fiber may improve general gastrointestinal health but does not address the esophageal spasms specifically. Thus, antispasmodics remain the first-line therapeutic approach in managing the symptoms associated with diffuse esophageal spasm.