Hypercontracting (nutcracker) esophagus

Assoc Prof Craig Hacking and Radswiki et al.

Hypercontracting (nutcracker) esophagus is a motility disorder of the esophagus. This condition is primarily diagnosed with manometry with high intra-esophageal pressure and normal peristalsis. Most patients will have a normal barium swallow

Hypercontracting esophagus ("nutcracker esophagus") differs from diffuse esophageal spasm (corkscrew esophagus)

Hypercontracting esophagus occurs in 10% of patients with non-cardiac chest pain. 

Presentation includes chest pain, dysphagia, and gastro-esophageal reflux disease.

Etiology is unknown but may be related to gastro-esophageal reflux or stress 2.  

A barium swallow is usually normal. A minority of patients may demonstrate features of non-specific esophageal motility disorder 1,2.  

Oesophageal pathology
Inspired signs

Article information

rID: 12800
Section: Signs
Synonyms or Alternate Spellings:
  • Hypercontracting esophagi
  • Hypercontracting esophaguses
  • Hypercontracting oesophaguses
  • Hypercontracting oesophagi
  • Nutcracker esophagi
  • Nutcracker esophaguses
  • Nutcracker oesophagi
  • Nutcracker oesophaguses
  • Nutcracker oesophagus
  • Nutcracker esophagus
  • Hypercontracting oesophagus
  • Hypercontracting esophagus
  • Jackhammer oesophagus

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Cases and figures

  • Figure 1: nutcracker (photo)
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