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USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


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  #1  
Old 07-26-2014
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Default DES......

For diffuse esophageal spasm....
I thought the diagnosis was simply manometry the treatment was Ca channel blockers.

Someone told me you do Barium swallow first then the most accurate is manometry.
And then they said in treatment first you try PPI's then if that fails do Ca channel blockers. Im confused now....anyone know for sure?
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  #2  
Old 07-26-2014
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Originally Posted by fixer View Post
For diffuse esophageal spasm....
I thought the diagnosis was simply manometry the treatment was Ca channel blockers.

Someone told me you do Barium swallow first then the most accurate is manometry.
And then they said in treatment first you try PPI's then if that fails do Ca channel blockers. Im confused now....anyone know for sure?
U world says to do manometry; in fact that's the answer for the questions U world has on this topic; and then you can give anti-spasmodics, or nitro.
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Old 07-26-2014
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U world says to do manometry; in fact that's the answer for the questions U world has on this topic; and then you can give anti-spasmodics, or nitro.


So does that mean manometry is best initial and most accurate and barium has no place in diagnosis.
Also do PPI's have any place in trearment?
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  #4  
Old 07-26-2014
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Quote:
Originally Posted by fixer View Post
U world says to do manometry; in fact that's the answer for the questions U world has on this topic; and then you can give anti-spasmodics, or nitro.


So does that mean manometry is best initial and most accurate and barium has no place in diagnosis.
Also do PPI's have any place in trearment?
Uworld hasn't mentioned barium at all...Step up to medicine says that Manometry is diagnostic. They have mentioned Barium, but just that it shows corkscrew esophagus. No, PPIs don't, according to step up...its Nitrates and CCBs...and then TCA's may provide symptomatic relief.
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Old 07-27-2014
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Originally Posted by CisternaChyli View Post
Uworld hasn't mentioned barium at all...Step up to medicine says that Manometry is diagnostic. They have mentioned Barium, but just that it shows corkscrew esophagus. No, PPIs don't, according to step up...its Nitrates and CCBs...and then TCA's may provide symptomatic relief.
The first step in working up a motility problem/dyspagia should be barrium swallow to rule out stuff like achalasia, pseudoachalasia obstructive cancers, strictures, etc.
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