Question:medium
Regarding nutcracker esophagus, the correct statement is:
Regarding nutcracker esophagus, the correct statement is:
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The name itself hints at crushing, high-pressure squeezing of the food pipe.
Updated On: Jun 23, 2026
- There is extremely forceful peristaltic activity leading to episodes of chest pain and dysphagia
- There is no medical treatment available
- It is a type of oesophageal malignancy
- None of the above
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The Correct Option is A
Solution and Explanation
Mnemonic angle: a nutcracker crushes with extreme force, and that is exactly what this esophagus does to a food bolus.
Take the options one by one. It is not a cancer, so rule out option 3. There IS treatment, so option 2 is false. That leaves the description of powerful peristalsis.
This is a hypermotility disorder. The peristaltic waves stay coordinated (unlike diffuse esophageal spasm) but the contraction amplitude is abnormally high. The patient feels episodic, squeezing chest pain that is often mistaken for angina, along with intermittent difficulty swallowing both solids and liquids. Diagnosis is by high-resolution manometry. Because the muscle is overactive, smooth-muscle relaxants help, so nitrates and nifedipine form the mainstay, with botulinum toxin or myotomy reserved for refractory cases.
Ref: Davidson's Principles and Practice of Medicine, 23e, p.795.
Take the options one by one. It is not a cancer, so rule out option 3. There IS treatment, so option 2 is false. That leaves the description of powerful peristalsis.
This is a hypermotility disorder. The peristaltic waves stay coordinated (unlike diffuse esophageal spasm) but the contraction amplitude is abnormally high. The patient feels episodic, squeezing chest pain that is often mistaken for angina, along with intermittent difficulty swallowing both solids and liquids. Diagnosis is by high-resolution manometry. Because the muscle is overactive, smooth-muscle relaxants help, so nitrates and nifedipine form the mainstay, with botulinum toxin or myotomy reserved for refractory cases.
Ref: Davidson's Principles and Practice of Medicine, 23e, p.795.
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