Jackhammer esophagus (JE) is a recently recognized esophageal motility disorder 
that is characterized by hypercontractile peristalsis. More than 500 cases have 
been reported in the literature. Among patients referred for esophageal motility 
disorders, the prevalence of JE ranges from 0.42% to 9%, with most series 
describing a prevalence of 2% to 4%. Most cases are women (60.5%). The mean 
reported age of patients with JE is 65.2 years, and patients commonly have 
dysphagia (62.8%). Reflux symptoms occur in ∼40% of patients, and chest pain 
affects more than one-third of patients (36.4%). JE is a heterogenous disorder 
that is associated with several conditions, including obesity, opioid use, lung 
transplantation, eosinophilic infiltration of the esophagus, neoplasia, and 
systemic diseases. The cause and pathogenesis remain unknown, but several 
observations suggest that it is the result of multiple conditions that likely 
precipitate increased excitation and abnormal inhibition of neuromuscular 
function. The natural course of JE also is unknown, but progression to achalasia 
has been observed in a few patients. Treatment is challenging, in part because 
of the insufficient understanding of the disorder's underlying mechanisms. 
Various therapeutic modalities have been used, ranging from observation only to 
pharmacologic and endoscopic interventions (eg, botulinum toxin injection) to 
peroral endoscopic myotomy. Treatment efficacy remains largely anecdotal and 
insufficiently studied.