Corkscrew esophagus is seen in which of the following conditions ?

• Esophageal contractions are repetitive, simultaneous, and of high amplitude. • Basic pathology is related to a motor abnormality of the esophageal body that is most notable in the lower two thirds of the esophagus. • More common in women and is often found in patients with multiple complaints. Clinical Features] • Clinical presentation: Chest pain and dysphagia (may be related to eating or exertion and may mimic angina) • Complain of a squeezing pressure in the chest that may radiate to the jaw, arms, and upper back. • The symptoms are often pronounced during times of heightened emotional stress. Diagnosis • Barium swallow: −− Corkscrew or rosary-bead esophagus, segmental spasm or pseudodiverticulosis appearance −− Due to presence of tertiary contractions −− Indicative of advanced disease • Hypermotility disorder also known as supersqueeze esophagus. • Esophagus with hypertensive peristalsis or high-amplitude peristaltic contractions. • Most common and most painful esophageal hypermotility disorder. • Associated with hypertrophic musculature resulting in high-amplitude contractions of the esophagus Clinical Features • Chest pain and dysphagia are typical symptoms. Diagnosis • The gold standard of diagnosis is the subjective complaint of chest pain with simultaneous objective evidence of peristaltic esophageal contractions 2 standard deviations above the normalQ values on manometric tracings. • On manometry, amplitude >180 mmHg and duration of contraction >6 seconds Treatment • The treatment of nutcracker esophagus is medical (Calcium channel blockers, nitrates, and antispasmodics)  • The LES pressure is above normal, motility of esophageal body may be hyperperistaltic or normal. Clinical Features • Patients with hypertensive LES present with chest pain or dysphagiaQ. Diagnosis • Diagnosis is made by manometry. −− Elevated LES pressure (>26 mm Hg) and normal relaxation of the LES. −− Esophageal body may be hyperperistaltic or normal. Treatment • Botox injections alleviate symptoms temporarily, and hydrostatic balloon dilation may provide long-term symptomatic relief. • Surgery in patients who fail interventional treatments and those with significant symptoms. • A laparoscopic modified Heller esophagomyotomy is the operation of choice.