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Esophageal dyskinesia in children: causes, symptoms, diagnosis, treatment

Alexey Kryvenko, medical expert
Last reviewed: 06.07.2025

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Esophageal dyskinesia is a disorder of esophageal motility in the absence of gastroesophageal reflux and signs of inflammation of the mucous membrane.

Code according to MKV-10

K22.4. Esophageal dyskinesia.

Classification of esophageal dyskinesia

Violation of peristalsis of the thoracic esophagus:
- hypermotor dyskinesia (segmental esophageal spasm - "nutcracker esophagus", diffuse esophageal spasm, nonspecific movement disorders);
- hypomotor dyskinesia.
Disruption of the esophageal sphincters:
- lower (cardiac insufficiency - gastroesophageal reflux, cardiospasm);
- top.

Causes and pathogenesis of esophageal dyskinesia

Primary and secondary dyskinesia of the esophagus are distinguished. Presumably, the pathogenesis of primary dyskinesia is based on changes in the nervous and humoral regulation of the esophagus, and secondary dyskinesia is considered as symptoms of diseases of the esophagus, other organs and systems.

Symptoms of esophageal dyskinesia

Hypermotor dyskinesia of the esophagus is characterized by chest pain, a lump in the throat sensation, which often occurs with neuroses and hysteria due to spasm of the initial sections of the esophagus. Dysphagia (in 90% of patients) is inconstant, paradoxical (difficulty in passing liquid food with normal swallowing of thick food), with an increase in symptoms from too hot or cold food, as well as with psychoemotional stress. At an early age, attacks of apnea, bradycardia, and periodic regurgitation are possible.

In case of hypomotor dyskinesia of the esophagus, dysphagia, a feeling of heaviness in the epigastric region after eating, aspiration of food with the development of chronic bronchitis and pneumonia, endoscopic picture of esophagitis, and decreased pressure in the lower esophageal sphincter occur.

When the upper esophageal sphincter is impaired, swallowing is difficult due to weakening of the sphincter and the esophageal-pharyngeal reflex; when the lower sphincter is affected, there is cardiospasm with a vivid psychosomatic picture, a constant sensation of a lump in the throat, increased breathing and complaints of lack of air, choking on food, a burning sensation and pain behind the breastbone, heartburn, belching of air and eaten food.

Diagnosis of esophageal dyskinesia

Endoscopically, the esophageal mucosa appears normal; spasms can be detected by X-ray. The diagnosis is established based on data obtained during esophageal manometry.

Differential diagnostics

Esophageal dyskinesia is differentiated from developmental anomalies of the esophagus and main vessels, gastroesophageal reflux disease.

Treatment of esophageal dyskinesia

Treatment of esophageal dyskinesia includes the elimination of psychotraumatic situations, a diet excluding spicy, cold and very hot food, as well as drug antispasmodic therapy (slow calcium channel blockers, nitrates, see above). Data on the effectiveness of antidepressants and psychotherapy have been published.

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