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