Esophageal motility disorders are characterized by abnormal function of the upper esophageal sphincter, lower esophageal sphincter (LES), or the body of the esophagus. This can lead to many clinical presentations, including dysphagia, chest pain, refractory gastroesophageal reflux disease (GERD), and food impactions. Motility disorders can present in isolation or as a manifestation of a systemic disease process. Several types of motility disorders exist:

• Diffuse esophageal spasm (DES) – Dysphagia to solids and liquids characterized by difficulty swallowing several seconds after initiating a swallow. Dysphagia is often associated with retrosternal chest pain, heartburn, and regurgitation of food.
• Nutcracker esophagus – Strong esophageal contractions associated with odynophagia or chest pain. Less commonly associated with regurgitation.
• Achalasia – Loss of ganglion cells in the LES, leading to hypertrophy of the LES and dilation of the proximal esophagus. Characterized by dysphagia, regurgitation, and chest pain. Esophagoscopy may show a corkscrew esophagus.