<s>[INST] context: Diffuse Esophageal Spasm 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 feature Clinical presentation: Chest pain and dysphagia (may be related to eating or exeion and may mimic angina) Complain of 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 pseudodiveiculosis appearance Due to presence of teiary contractions Indicative of advanced disease Manometry is gold standard test for diagnosis. Treatment: Mainstay of treatment for DES is nonsurgical, and pharmacologic (Nitrates, calcium channel blockers) or endoscopic intervention (Bougie dilation) is preferred. Indications of surgery (long esophagomyotomy): Incapacitating chest pain or dysphagia who have failed medical and endoscopic therapy Presence of pulsion diveiculum of the thoracic esophagus [/INST] question: Corkscrew esophagus is seen in which of the following condition? | options: A: Carcinoma esophagus B: Scleroderma C: Achalasia cardia D: Diffuse esophageal spasm | answer: D </s>